Healthcare Provider Details

I. General information

NPI: 1164958856
Provider Name (Legal Business Name): EVAN YOUNT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 07/31/2020
Certification Date: 07/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 SENECA ST MAIL STOP H8-GME
SEATTLE WA
98101-2742
US

IV. Provider business mailing address

925 SENECA ST MAIL STOP H8-GME
SEATTLE WA
98101-2742
US

V. Phone/Fax

Practice location:
  • Phone: 206-583-6079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD61045880
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: