Provider Demographics
NPI:1609911304
Name:EVANS, ROY CLARK (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:CLARK
Last Name:EVANS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 STATE AVE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4556
Mailing Address - Country:US
Mailing Address - Phone:360-570-8151
Mailing Address - Fax:360-943-6602
Practice Address - Street 1:1217 4TH AVE E
Practice Address - Street 2:SUITE 200
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4246
Practice Address - Country:US
Practice Address - Phone:360-570-8151
Practice Address - Fax:360-943-6602
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH2803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2579480OtherAETNA
WA0292244OtherCIGNA
WAEV5391OtherREGENCE
WA0292244OtherCIGNA
WAEV5391OtherREGENCE