Individual
EVAN ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12729 NORTHUP WAY, SUITE 9, BELLEVUE, WA 98005
(866) 727-8274
(800) 459-4245
Mailing address
12729 NORTHUP WAY, SUITE 9, BELLEVUE, WA 98005
(866) 727-8274
(800) 459-4245
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61025799
WA
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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