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NPI Code Detail

MEDICARE: JEFFREY LEWIS EVANS MD

MEDICARE: JEFFREY LEWIS EVANS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianMD00046254WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326088014
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY LEWIS EVANS MD
Provider Business Mailing Address
First Line : PO BOX 25608
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84125-0608
Country : US
Telephone Number : 206-320-4476
Fax Number : 206-568-7043
Provider Business Practice Location Address
First Line : 1101 MADISON ST
Second Line : STE 1400
City : SEATTLE
State : WA
Zip : 98104-4308
Country : US
Telephone Number : 206-386-6266
Fax Number : 206-386-2844
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 08/09/2021

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Directions to “ JEFFREY LEWIS EVANS MD” Practice Location

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