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1710318837
KENNETH EVANGELISTA
EVERETT, WA
NPI
1710318837
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: WA AP60698654)
Enumeration Date
2013-11-30
Last Update Date
2019-12-11
Business Address
Mr. KENNETH EVANGELISTA
1321 COLBY AVE
EVERETT, WA 98201-1665
Phone number: 425-261-2000
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Mailing Address
Mr. KENNETH EVANGELISTA
PO BOX 3360
PORTLAND, OR 97208-3360
Phone number: 866-747-2455
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