Individual provider Active NPI

Nicole Nevan, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
National Provider Identifier
1295079879
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10052921 Issued in OR
Practice address
2645 Portland Rd NE Ste 120
Salem, OR 97301-0200
Phone
(503) 390-5637
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 201906417RN OR
Mental Health Counselor 101YM0800X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10052921 OR Primary

Addresses

Primary practice location

2645 Portland Rd NE Ste 120
Salem, OR 97301-0200

Mailing address

2645 Portland Rd NE Ste 120
Salem, OR 97301-0200
Phone (503) 390-5637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

360 E 10TH Ave
Suite 450
Eugene, OR 97401-5599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201906417RNORMDPsychiatric/Mental Health Registered Nurse
10052921ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services of Oregon Mental Health CurrentSince Apr 18, 2026 Accepting new patients

Locations

11010 SE Division St
Ste 202
Portland, OR 97266
Phone (503) 335-5975

2645 Portland Rd NE
Ste 120
Salem, OR 97301

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1295079879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 PORTLAND RD NE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010200",
            "telephone_number": "503-390-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 PORTLAND RD NE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010200",
            "telephone_number": "503-390-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVAN",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201906417RN",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10052921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.