Individual provider · NPI-1

Evan Bragin

Registered Nurse, Psych/Mental Health, Adult · Tacoma, WA

NPI number1902157852
StatusActive
Last updated in NPPESOct 1, 2012

Details

NPI
1902157852
Entity type
Individual (NPI-1)
Name
Evan Bragin
Sex
Male
Sole proprietor
No
Enumeration date
Oct 1, 2012
Last updated
Oct 1, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WP0809X Registered Nurse, Psych/Mental Health, Adult26NJoo375300NJYes

Practice location

9040 Jackson Ave
Mchj-Clq-C
Tacoma, WA 98431-1100

Phone 253-968-3564

Mailing address

9040 Jackson Ave
Mchj-Clq-C
Tacoma, WA 98431-1100

Phone 253-968-3564

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