Individual
MICHAEL B EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5228 NE HOYT ST BLDG B, PORTLAND, OR 97213-3055
(503) 215-6474
Mailing address
4834 NE 26TH AVE, PORTLAND, OR 97211-6319
(503) 281-8177
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15-11-03
OR
1041C0700X
Clinical Social Worker
Primary
L3777
OR
Other
Enumeration date
10/25/2013
Last updated
03/17/2017
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