Healthcare Provider Details
I. General information
NPI: 1689608648
Provider Name (Legal Business Name): EVA M. KHAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1959 NE PACIFIC ST CAMPUS BOX 354765
SEATTLE WA
98195-0001
US
IV. Provider business mailing address
PO BOX 24366 M/S 359107
SEATTLE WA
98124-0366
US
V. Phone/Fax
- Phone: 206-598-5500
- Fax: 206-598-8722
- Phone: 206-598-8920
- Fax: 206-598-7663
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | AP30003463 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN00059104 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: