Provider Demographics
NPI:1619786621
Name:REDING, EVAN KERRY
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:KERRY
Last Name:REDING
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 15TH AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2673
Mailing Address - Country:US
Mailing Address - Phone:206-552-3032
Mailing Address - Fax:
Practice Address - Street 1:701 N 36TH ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8868
Practice Address - Country:US
Practice Address - Phone:206-216-5000
Practice Address - Fax:206-216-5002
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist