MEDICARE: CHRISTOPHER EVANS

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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1326459504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER EVANS

Provider Business Mailing Address
First Line	:	453 N BEACH RD
Second Line	:
City	:	EASTSOUND
State	:	WA
Zip	:	98245-8927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	453 N BEACH RD
Second Line	:
City	:	EASTSOUND
State	:	WA
Zip	:	98245-8927
Country	:	US
Telephone Number	:	360-376-4002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2014
Last Update Date	:	05/09/2014

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Directions to “ CHRISTOPHER EVANS ” Practice Location

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