Evan James Evans

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1601 E 4TH Plain Blvd
BLDG 17 Ste B222
Vancouver, WA 98661-3713

Phone

(360) 397-8484

Fax

(360) 397-8494

NPI assigned

May 18, 2016

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

Other names 1

• Jimi Evans Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 17, 2024 through Sep 17, 2026

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.

• Community Services Northwest

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1720176894
  NPD (past)

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1689021784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681845",
            "telephone_number": "360-397-8484",
            "fax_number": "360-397-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD",
            "address_2": "BLDG 17 STE B222",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613713",
            "telephone_number": "360-397-8484",
            "fax_number": "360-397-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIMI",
            "last_name": "EVANS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carlin Evanoff, PA-C
• Brenda L Evans, LPN
• Christopher Scott Evans
• Destiny Evans
• Elizabeth Lewis Evans, PT, DPT
• Jennie Anne Evans, RN60828845
• Jodi Evans
• Kathryn Ellysa Evans
• Matthew Evans, MD
• Rebecca Sameck Evans, RN, BSN

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.