Evan Walker Prewitt – Nurse's Aide in Longview, WA

Key facts

NPI: 1801612866
Entity type: Individual (NPI type 1)
Primary specialty: Nurse's Aide 376K00000X
License: NC61544604 (WA)
Practice address: 720 14TH Ave
Longview, WA 98632-2315
Phone: (360) 423-0203
Fax: (360) 577-0187
NPI assigned: Nov 25, 2024
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Columbia Wellness Case Management Agency · Longview, WA · NPI 1487659579

NPD

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
NC61544604	WA	MD	Nurse's Aide

Practice roles

Organization	Specialty	Status	New patients
Columbia Wellness		Current since Dec 1, 2024	Accepting new patients

Locations

720 14th Ave
Longview, WA 98632

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse's Aide	376K00000X	NC61544604	WA	Yes

Addresses

Primary practice location

720 14TH Ave
Longview, WA 98632-2315

Mailing address

PO Box 1847
Longview, WA 98632-8140
Phone (360) 423-0203

Other providers in Longview, WA

All providers in Longview, WA · Nurse's Aide in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.