Provider Demographics
NPI:1407526817
Name:EVANS, JAMES MCCALL III (GRADUATE STUDENT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MCCALL
Last Name:EVANS
Suffix:III
Gender:M
Credentials:GRADUATE STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4039 8TH AVE NE APT L06
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6480
Mailing Address - Country:US
Mailing Address - Phone:206-833-9224
Mailing Address - Fax:
Practice Address - Street 1:999 164TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-3518
Practice Address - Country:US
Practice Address - Phone:425-747-4937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health