Healthcare Provider Details

I. General information

NPI: 1679420376
Provider Name (Legal Business Name): ERIN EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

1406 P ST NW # 2
WASHINGTON DC
20005-1998
US

V. Phone/Fax

Practice location:
  • Phone: 240-273-1601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA2000053
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: