Abby Marie Everaerts, PSYD, M.S.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

00000 Issued in OR

Practice address

20 SE 103Rd Ave
Portland, OR 97216-2866

Phone

(360) 574-9565

Fax

(360) 574-9685

NPI assigned

Sep 20, 2012

Last updated

Oct 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

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
  • Vancouver, WA
  • NPI 1659482925
  NPD (past)

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1821349556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE",
            "address_2": "SUITE 215",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854599",
            "telephone_number": "360-574-9565",
            "fax_number": "360-574-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SE 103RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162866",
            "telephone_number": "360-574-9565",
            "fax_number": "360-574-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERAERTS",
        "first_name": "ABBY",
        "middle_name": "MARIE",
        "credential": "PSYD, M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John Ohara Evered, MD, MPH
• Everett & Flanders House Community Club
• Benjamin Everett

• 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 Oct 9, 2015; 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.