Provider Demographics
NPI:1245645092
Name:EVANS, NATASHA IMAI (PT, DPT)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:IMAI
Last Name:EVANS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:IMAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8510 BRYANT ST STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3845
Mailing Address - Country:US
Mailing Address - Phone:720-497-6666
Mailing Address - Fax:
Practice Address - Street 1:8510 BRYANT ST STE 130
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3845
Practice Address - Country:US
Practice Address - Phone:720-497-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist