Stacy Jean Evanger, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

901 Rainier Ave S
Seattle, WA 98144-2839

Phone

(206) 889-0569

NPI assigned

Jan 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stacy Jean Evanger-Jenkins Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pioneer Human Services

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1265554463
  NPD (past)

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1326555293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SW 135TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981463147",
            "telephone_number": "206-391-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442839",
            "telephone_number": "206-889-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGER",
        "first_name": "STACY",
        "middle_name": "JEAN",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDP",
            "identifier": "CP60390363",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "EVANGER-JENKINS",
            "middle_name": "JEAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole M Eul, LPC, SAC, LMHC
• Steve M Eulau, M.D.
• John David Eun, MD, PHD
• Sean Scott Eusantos
• Aaron J Eusterbrock, PA-C
• Lisa Nichole Evanoff, PA-C, RD
• Zoe J Evans-Agnew
• Alexandra Evans, PA-C
• Amanda Evans, LMHCA
• Amanda Leigh Evans, LMHCA

• Addiction (Substance Use Disorder) Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.