Carlin Evanoff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60747576 Issued in WA

Practice address

100 E 33Rd St Ste 100
Vancouver, WA 98663-2776

Phone

(360) 514-7550

Fax

(360) 514-7553

NPI assigned

Dec 3, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlin.evanoff.p1@direct.mshs.nextgenshare.com
• Direct secure messaging: cevanoff346604@direct.peacehealth.org

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.

• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Medicare reassignment NPD
• Peacehealth

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment NPD
• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1881025708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 W SPRUCE AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545327",
            "telephone_number": "907-376-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 33RD ST STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632776",
            "telephone_number": "360-514-7550",
            "fax_number": "360-514-7553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3240 NE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986072408",
            "country_code": "US",
            "telephone_number": "360-729-8234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 NE 192nd Ave Ste. 310",
            "address_purpose": "LOCATION",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "98607",
            "country_code": "US",
            "telephone_number": "360-729-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 NE 87th Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641965",
            "country_code": "US",
            "telephone_number": "360-514-6450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16811 SE McGillivray Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986833404",
            "country_code": "US",
            "telephone_number": "360-735-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Main St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986632223",
            "country_code": "US",
            "telephone_number": "360-696-5232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1363 W Spruce Ave",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996545327",
            "country_code": "US",
            "telephone_number": "907-376-2411 x355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANOFF",
        "first_name": "CARLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": "06-772-P",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "2301",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60747576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Destiny Evans
• Elizabeth Lewis Evans, PT, DPT
• Evan James Evans

• Physician Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.