Kevin Shank

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

23-11-30089 Issued in OR

Practice address

33 NW Broadway
Portland, OR 97209-3580

Phone

(503) 944-4410

NPI assigned

Jul 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Lifeworks NW

  • Mental Health Counselor
  • Portland, OR
  • NPI 1467408013
  NPD (past)

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1760867659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10759 SW HERON CIR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970078353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 NW BROADWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093580",
            "telephone_number": "503-944-4410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14255 SW Brigadoon Ct",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970053369",
            "country_code": "US",
            "telephone_number": "503-641-1475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANK",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-21",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L17410",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "23-11-30089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanan Shang, M.D.
• Kirsten Celanire Shangraw, DPT
• Patricia F Shangraw, FAMILY NURSE PRACTIT
• Robert Edward Shangraw, M.D.
• Heather Shank, LCSW
• Renee Mendonca Shankar, L.AC
• Vijay Shankar, PSY.D.
• Vikram Shankar, MD
• Landyn Laree Shanks, D.C.
• Lorna Jean Shanks, MD

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.