Provider Demographics
NPI:1629650718
Name:EVANS, CAITLIN JEANNE THERESE (PA-S)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:JEANNE THERESE
Last Name:EVANS
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:JEANNE THERESE
Other - Last Name:JARRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1441 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-5420
Mailing Address - Country:US
Mailing Address - Phone:208-642-9376
Mailing Address - Fax:208-642-9598
Practice Address - Street 1:2327 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-1851
Practice Address - Country:US
Practice Address - Phone:541-889-2340
Practice Address - Fax:541-889-2593
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA217184363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant