Provider Demographics
NPI:1528637436
Name:LE, EVELYN (ND)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22635 NE MARKETPLACE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-5886
Mailing Address - Country:US
Mailing Address - Phone:425-949-5961
Mailing Address - Fax:
Practice Address - Street 1:22635 NE MARKETPLACE DR STE 130
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5886
Practice Address - Country:US
Practice Address - Phone:425-949-5961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANATU.NT.61193852171400000X, 207Q00000X, 2083P0901X, 405300000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171400000XOther Service ProvidersHealth & Wellness Coach
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No405300000XOther Service ProvidersPrevention Professional