Individual
JACQUELINE P EVANS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA, ARNP
Contact information
Practice address
6520 226TH PL SE, STE 120, ISSAQUAH, WA 98027-7371
(425) 830-5574
Mailing address
PO BOX 1143, FALL CITY, WA 98024-1143
(425) 830-5574
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30001334
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040217
LABOR & INDUSTRY
WA
01
—
380452001
GROUP HEALTH
WA
05
—
9611047
—
WA
01
—
EV3488
REGENCE BLUE CROSS/SHIELD
WA
Enumeration date
06/08/2006
Last updated
03/09/2019
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