Provider Demographics
NPI:1326847476
Name:FISHELL, EVAN F
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:F
Last Name:FISHELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MASSACHUSETTS AVE NW APT 721
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-1833
Mailing Address - Country:US
Mailing Address - Phone:724-766-0665
Mailing Address - Fax:
Practice Address - Street 1:1517 18TH ST NW FL 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1305
Practice Address - Country:US
Practice Address - Phone:202-817-9042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker