MEDICARE: LAUREN ELIZABETH EVANS M.D.

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	208D00000X	General Practice Physician	MD00023634	WA

Other Identifiers

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

General Provider Information

NPI Number	:	1508042250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELIZABETH EVANS M.D.

Provider Business Mailing Address
First Line	:	2120 RAINIER AVE S
Second Line	:	SUITE B
City	:	SEATTLE
State	:	WA
Zip	:	98144-4623
Country	:	US
Telephone Number	:	206-328-0546
Fax Number	:	206-328-0489

Provider Business Practice Location Address
First Line	:	2120 RAINIER AVE S
Second Line	:	SUITE B
City	:	SEATTLE
State	:	WA
Zip	:	98144-4623
Country	:	US
Telephone Number	:	206-328-0546
Fax Number	:	206-328-0489

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

Provider Enumeration Date	:	01/11/2008
Last Update Date	:	05/11/2011

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