Basic Information
Provider Information
NPI: 1992824528
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EVANS
FirstName: ROBYN
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5371
Address2: CSB 200
City: SEATTLE
State: WA
PostalCode: 981454320
CountryCode: US
TelephoneNumber: 2069872000
FaxNumber:  
Practice Location
Address1: 4800 SAND POINT WAY NE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981053901
CountryCode: US
TelephoneNumber: 2069872000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2007
LastUpdateDate: 12/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP60339720WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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