Evans, Kelly L

Evans, Kelly L is an individual health care provider with primary practice located at 4545 Cordata Pkwy , Bellingham WA 98226-7123. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Evans, Kelly L can be contacted via phone (360) 738-2200.

Contact Information

Primary practice address
4545 Cordata Pkwy Bellingham WA 98226-7123
Fax: (360) 752-5686
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36096988 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD60114770 Washington

Profile Details

NPI number 1700887338
LBN Legal business name Evans, Kelly L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2005
Last updated Sep 22nd, 2010 - about 14 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 1700887338 NPPES
Washington MEDICAID 1700887338
Washington MEDICAID 036096988
Washington Other 0031EV
Washington Other 0261814
Washington Other 5827708

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