RUSSELL L EVANS PA-C
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1851871172- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA-C
- Status
- Active
Contact & Location
- Address
- 320 WARNER DR, LEWISTON, ID, 835014441
- Phone
- (208) 743-3523
- Fax
- (208) 746-8741
Specialties & Taxonomies
Radiology, Vascular & Interventional Radiology
License: ID #1851871172
Radiologic Technologist, Computed Tomography
License: MN #408447
Radiologic Technologist, Radiography
License: MN #408447
Physician Assistant
License: WA #PA61007077
Physician Assistant
Primary License: ID #PA-1823