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General NPI Number Information
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NPI Number | 1841174265
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Entity Type | Individual
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Provider Name | NATHANIEL BROR EVANS DPT
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Gender | Male
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3209 S 23RD ST STE 100
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City | TACOMA
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State | WA
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Zip | 98405-1602
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Country | US
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Telephone | 253-503-6876
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Fax |
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Provider Business Mailing Address
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Address Line | 6050 TACOMA MALL BLVD STE 300
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City | TACOMA
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State | WA
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Zip | 98409-6828
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT7343
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License Number State | ME
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