Ebalo, Evelyn Ebarle

Ebalo, Evelyn Ebarle is an individual health care provider with primary practice located at 1920 Black Lake Blvd Sw , Olympia WA 98512-5651. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ebalo, Evelyn Ebarle can be contacted via phone (360) 534-9222.

Contact Information

Primary practice address
1920 Black Lake Blvd Sw Olympia WA 98512-5651
Fax: (360) 534-9223
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00028453 Washington

Profile Details

NPI number 1881671618
LBN Legal business name Ebalo, Evelyn Ebarle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881671618 NPPES
Washington Other EB5698 REGENCE
Washington MEDICAID 8128340 REGENCE

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