Healthcare Provider Details

I. General information

NPI: 1689598021
Provider Name (Legal Business Name): KYLA EVANS LMT, MLD-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511A FAIRBANKS ST
ANCHORAGE AK
99503-2821
US

IV. Provider business mailing address

5221 RABBIT CREEK RD
ANCHORAGE AK
99516-4905
US

V. Phone/Fax

Practice location:
  • Phone: 907-727-7571
  • Fax:
Mailing address:
  • Phone: 907-727-7571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number243380
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: