Provider Demographics
NPI:1316222466
Name:EVANGER-DALKE, TARA ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:ELIZABETH
Last Name:EVANGER-DALKE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:ELIZABETH
Other - Last Name:EVANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX O
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-0212
Mailing Address - Country:US
Mailing Address - Phone:509-540-3937
Mailing Address - Fax:509-540-3938
Practice Address - Street 1:1610 PENNY LN
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362
Practice Address - Country:US
Practice Address - Phone:509-540-3937
Practice Address - Fax:509-540-3938
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR37348152W00000X
WA60485177152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist