Susan Evans, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2601 Issued in OR

Practice address

516 SE Morrison St
Suite 510
Portland, OR 97214-2327

Phone

(503) 914-0250

NPI assigned

Jan 12, 2011

Last updated

Feb 18, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geromedical Psychological Service PS

  • Clinical Psychologist
  • Portland, OR
  • NPI 1043501836
  NPD (past)
• Geromedical Psychological Service PS

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1659482925
  NPD (past)

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1740585306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 SE HAWTHORNE BLVD # 235",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SE MORRISON ST",
            "address_2": "SUITE 510",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142327",
            "telephone_number": "503-914-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rolann Brooke Evans, CADC-R
• Sandra Kay Evans
• Sandy Lynn Evans, L.AC.
• Shane Robert Evans, B.S./ QMHA
• Sharon Evans, CPM, LDM
• Tabitha Evans, PSYD
• Zenobia L Evans
• Haley J Evashenk, PT, DPT
• Eve Chiropractic Clinic LLC
• Kyle Avery Eveland-Dewan

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.