Evan Ross Dupuis

Individual provider Active NPI Athletic Trainer · Cheney, WA

NPI 1154448009 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154448009
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
1951 1St St
Cheney, WA 99004-2000
Phone
(509) 559-5038
NPI assigned
Mar 24, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

1951 1St St
Cheney, WA 99004-2000

Mailing address

111 College Hill St Apt 78
Cheney, WA 99004-2029
Phone (509) 936-0961

Other providers in Cheney, WA

All providers in Cheney, WA · Athletic Trainer in Washington

Sources for this page

Verify at the official NPI Registry.