Evetts, Brent K

Evetts, Brent K is an sole proprietor health care provider with primary practice located at 19875 Sw 65Th Ave Suite 260, Tualatin OR 97062-8353. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Evetts, Brent K can be contacted via phone (503) 691-1743.

Contact Information

Primary practice address
19875 Sw 65Th Ave Suite 260 Tualatin OR 97062-8353
Phone: (503) 691-1743
Fax: (503) 691-0983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD20653 Oregon
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X MD20653 Oregon
Allopathic & Osteopathic Physicians / Surgery 208600000X MD20653 Oregon

Profile Details

NPI number 1538291547
LBN Legal business name Evetts, Brent K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 12th, 2007
Last updated Apr 17th, 2023 - about last year

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 1538291547 NPPES
Oregon MEDICAID 150330

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