Evans, Lisa M.

Evans, Lisa M. is an individual health care provider with primary practice located at 1615 Delaware St. , Longview WA 98632-0302. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Evans, Lisa M. can be contacted via phone (360) 414-2385.

Contact Information

Primary practice address
1615 Delaware St. Longview WA 98632-0302
Phone: (360) 414-2385
Fax: (360) 414-2386
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00044037 Washington

Profile Details

NPI number 1891790580
LBN Legal business name Evans, Lisa M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jan 10th, 2013 - about 13 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 1891790580 NPPES
Washington Other 0201114 LABOR & IND.
Washington MEDICAID 8435851 LABOR & IND.
Washington Other 8913895 LABOR & IND.
Washington Other P00293336 LABOR & IND.
Washington MEDICAID 270056 LABOR & IND.

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