Haley J Evashenk, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

64496 Issued in OR

Practice address

1630 SW Morrison St Ste 100
Portland, OR 97205-1916

Phone

(503) 227-7774

Fax

(503) 227-7548

NPI assigned

Sep 1, 2022

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 1, 2022.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1679293294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 SW MORRISON ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051916",
            "telephone_number": "503-227-7774",
            "fax_number": "503-227-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SW MORRISON ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051916",
            "telephone_number": "503-227-7774",
            "fax_number": "503-227-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVASHENK",
        "first_name": "HALEY",
        "middle_name": "J",
        "credential": "PT,  DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Portland, OR
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.