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General NPI Number Information
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NPI Number | 1861933996
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Entity Type | Individual
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Provider Name | JASMINE EVANS
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Gender | Female
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 104 S DIVISION ST
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City | SPOKANE
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State | WA
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Zip | 99202-1562
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Country | US
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Telephone | 509-747-7076
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Fax | 509-863-9265
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Provider Business Mailing Address
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Address Line | 10913 W 6TH AVE APT F131
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City | AIRWAY HEIGHTS
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State | WA
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Zip | 99001-5123
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Country | US
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Telephone | 575-313-6744
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 60662798
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License Number State | WA
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