Provider Demographics
NPI:1215181193
Name:EVANS, DAVID E (LMHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:EVANS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 E LAKE SAMMAMISH PKWY SE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-7424
Mailing Address - Country:US
Mailing Address - Phone:206-769-1344
Mailing Address - Fax:
Practice Address - Street 1:16307 NE 83RD ST
Practice Address - Street 2:SUITE 208
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1501
Practice Address - Country:US
Practice Address - Phone:206-769-1344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health