Individual
KEITH EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 CAPITOL MALL DR SW, OLYMPIA, WA 98502-8657
(360) 754-9792
Mailing address
1425 11TH AVE SW, OLYMPIA, WA 98502-5787
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7755
OR
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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