Organization Active NPI

Evercare Support LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1609737790
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
EVERCARE SUPPORT LLC
Practice address
1370 NW Division St
Gresham, OR 97030-5350
Phone
(206) 307-7941
NPI assigned
Nov 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Kidus JaleleNPI 1326902057
Title
Adminstrator
Phone
(206) 307-7941

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1370 NW Division St
Gresham, OR 97030-5350

Mailing address

1370 NW Division St
Gresham, OR 97030-5350
Phone (206) 307-7941

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1609737790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305350",
            "telephone_number": "206-307-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305350",
            "telephone_number": "206-307-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERCARE SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "JALELE",
        "authorized_official_first_name": "KIDUS",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "206-307-7941"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.