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Individual

MR. LEASEL WAYNE EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, MSN, PMHNP-BC

Contact information

Practice address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
(503) 653-1464
Mailing address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
(503) 653-1464

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
201406240RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201709151NP-PP
OR

Other

Enumeration date
11/06/2014
Last updated
01/16/2025
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