Michael B Evans

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3777 Issued in OR

Practice address

5228 NE Hoyt St BLDG B
Portland, OR 97213-3055

Phone

(503) 215-6474

NPI assigned

Oct 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1255769477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4834 NE 26TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116319",
            "telephone_number": "503-281-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 NE HOYT ST BLDG B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133055",
            "telephone_number": "503-215-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-25",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-11-03",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Evans
• Madeline Danielle Evans, MD
• Matthew Michael Evans, DO
• Melissa Evans
• Miara Danae Evans
• Michael Eldon Evans, BA
• Nathan Evans
• Nicholas James Evans, MD
• Nikia C Evans, MD, MS
• Pamela Kay Evans, MS, RD, LD

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.