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
Phone: (360) 738-2200
Fax: (360) 752-5686
Website:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700887338 | NPPES |
| Washington | MEDICAID | 1700887338 | |
| Washington | MEDICAID | 036096988 | |
| Washington | Other | 0031EV | |
| Washington | Other | 0261814 | |
| Washington | Other | 5827708 |
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