Shane Douglas Roush

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-22-1832 Issued in OR

Practice address

195 W 12TH Ave
Eugene, OR 97401-3408

Phone

(541) 762-4300

NPI assigned

Mar 7, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1295593937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 CHESHIRE AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W 12TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013408",
            "telephone_number": "541-762-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "SHANE",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-22-1832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Roth, LCSW
• Zachary Austin Roth, PA
• Matthew Rothermund
• Hsiao-Ching Daisy Rothgery X, RN,MS
• Helene Roumegous, RN
• Louise Breum Rousseau, DO
• Zackary Dion Rousseau
• Denise Diane Routhier, M.D.
• Dorothy Karnis Row, FNP-BC
• Stacie Rowan, PH.D.

• Addiction (Substance Use Disorder) Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.