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General NPI Number Information
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NPI Number | 1073315115
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Entity Type | Individual
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Provider Name | CASSIDY EVANS
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 302-379-4463
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Fax |
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Provider Business Mailing Address
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Address Line | 2408 BRAKEN AVE
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City | WILMINGTON
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State | DE
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Zip | 19808-4432
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 033.0135828
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License Number State | VT
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