Healthcare Provider Details

I. General information

NPI: 1437248655
Provider Name (Legal Business Name): JOHN RICHARD EVANS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST B241 HSB
SEATTLE WA
98195-7134
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX 357131
SEATTLE WA
98195-7131
US

V. Phone/Fax

Practice location:
  • Phone: 206-534-7722
  • Fax: 206-685-7222
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDE00004613
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: