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Individual

KELSEY JOAN EVINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
121 N DIVISION ST STE 310, AUBURN, WA 98001-4931
(253) 545-5978
Mailing address
1116 OFARRELL LN NW, ORTING, WA 98360-7418
(541) 379-1825

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160969833
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000028155
CERTIFICATION NUMBER-BOC
01
73575
NATA
01
A160969833
STATE OF WASHINGTON LICENSE
WA
Enumeration date
07/15/2022
Last updated
07/15/2022
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