Individual
RUSSELL L EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Mailing address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 208-8741
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
1851871172
ID
2471C3401X
Computed Tomography Radiologic Technologist
408447
MN
2471C3402X
Radiography Radiologic Technologist
408447
MN
363A00000X
Physician Assistant
Primary
PA-1823
ID
363A00000X
Physician Assistant
PA61007077
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851871172
—
ID
05
—
1851871172
—
WA
Enumeration date
08/16/2018
Last updated
06/03/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us