Provider Demographics
NPI:1902387574
Name:BEUS, EVAN CLARK (OD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:CLARK
Last Name:BEUS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 W OIE HWY
Mailing Address - Street 2:
Mailing Address - City:BENTON CITY
Mailing Address - State:WA
Mailing Address - Zip Code:99320-7696
Mailing Address - Country:US
Mailing Address - Phone:509-303-1031
Mailing Address - Fax:
Practice Address - Street 1:303 S 72ND AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-1661
Practice Address - Country:US
Practice Address - Phone:509-654-9256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60862626152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist