Individual provider Active NPI

Mari Kay Evans-Smith, MD

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1528064896
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD17819 Issued in OR
Practice address
2525 NW Lovejoy St
Ste 200
Portland, OR 97210-2863
Phone
(503) 227-0671
Fax
(503) 227-0676
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD17819 OR Primary

Addresses

Primary practice location

2525 NW Lovejoy St
Ste 200
Portland, OR 97210-2863

Mailing address

1502 NW Gregory Dr
Vancouver, WA 98665-6000
Phone (360) 576-7626

Other identifiers 1

IdentifierTypeStateIssuer
045620MedicaidOR

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17819ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of the Northwest, PC Pediatrics PastSince Dec 21, 2025 Accepting new patients
Pediatric Associates of the Northwest, PC Pediatrics PastSince Oct 25, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mkevanssmith@panw.pcc-direct.com

Organizations & group practices 2

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528064896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 NW GREGORY DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986656000",
            "telephone_number": "360-576-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW LOVEJOY ST",
            "address_2": "STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102863",
            "telephone_number": "503-227-0671",
            "fax_number": "503-227-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS-SMITH",
        "first_name": "MARI KAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD17819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045620",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.