Provider Demographics
NPI:1700188695
Name:EVANS, JASON (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:EVANS
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:DR
Other - First Name:I
Other - Middle Name:M
Other - Last Name:NEGATIVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:230 ROWE ST
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:OR
Mailing Address - Zip Code:97147
Mailing Address - Country:US
Mailing Address - Phone:844-715-2299
Mailing Address - Fax:844-715-3299
Practice Address - Street 1:230 ROWE ST
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:OR
Practice Address - Zip Code:97147
Practice Address - Country:US
Practice Address - Phone:844-715-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-26
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00108221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist