Healthcare Provider Details

I. General information

NPI: 1477071041
Provider Name (Legal Business Name): MORGAN WARWICK EVANS MD, FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DIVISION OF CRANIOFACIAL AND PLASTIC SURGERY 4800 SAND POINT WAY, NE, MS OB.9.520
SEATTLE WA
98105-0371
US

IV. Provider business mailing address

3837 AURORA AVE N APT 2
SEATTLE WA
98103-2720
US

V. Phone/Fax

Practice location:
  • Phone: 206-604-0765
  • Fax:
Mailing address:
  • Phone: 206-604-0765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMDFE.60738663
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: