| Doctor Name: | MR. RANDY GIILBERT EVARO |
| NPI Number: | 1689841140 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | COTA L |
| License Number: | 0C00001025 |
| Business Practice Address: | 800 N Medcalf Montesano, WA - 98563 |
| Business Phone Number: | 3602491610 |
| Business Fax Number: | 3602492376 |
| Mailing Address: | 2940 St Rt 109, OCEAN CITY |
| State: | WA |
| Postal Code: | 98569 |
| Phone Number: | 3605826008 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2008 |
| NPI Last Update Date: | 05/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 0C00001025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |