Evanetich, Cassandra

Evanetich, Cassandra is an individual health care provider with primary practice located at 1909 Mountain View Ln Ste 200 , Forest Grove OR 97116-2894. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Evanetich, Cassandra can be contacted via phone (503) 359-4773.

Contact Information

Primary practice address
1909 Mountain View Ln Ste 200 Forest Grove OR 97116-2894
Phone: (503) 359-4773
Fax: (503) 359-3809
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA195867 Oregon

Profile Details

NPI number 1093357378
LBN Legal business name Evanetich, Cassandra
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2019
Last updated May 4th, 2021 - about 3 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 1093357378 NPPES
Oregon MEDICAID 500753082

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