| Dr Katie Evans Inc | |
|
19943 Sw Jette Ln Beaverton OR 97006-2789 | |
| (503) 756-6117 | |
| (503) 524-3778 |
| Full Name | Dr Katie Evans Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 19943 Sw Jette Ln, Beaverton, Oregon |
| Authorized Official Name and Position | Katie Evans Kelley (TREATMENT DIRECTOR CEO) |
| Authorized Official Contact | 5037566117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Katie Evans Inc 19943 Sw Jette Ln Beaverton OR 97006-2789 Ph: (503) 756-6117 | Dr Katie Evans Inc 19943 Sw Jette Ln Beaverton OR 97006-2789 Ph: (503) 756-6117 |
| NPI Number | 1255500203 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 10/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255500203 | NPI | - | NPPES |
| 1615-01 | Other | PBH | |
| 100000012349 | Other | OR | REGENCE |
| 0001152747 | Other | MHN SERVICES | |
| 283365 | Other | OR | MULTIPLAN |
| 669401100000 | Other | OR | LIFEWISE |
| 3006890 | Other | OR | REGENCE BLUECROSS BLUESHIELD OF OREGON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 860106 (Oregon) | Secondary |
| 101YP2500X | Counselor - Professional | CP00004591 (Washington) | Primary |
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