Individual
EVAN MICHAEL THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12655 SW CENTER ST STE 100, BEAVERTON, OR 97005-1600
(503) 828-3402
Mailing address
16055 SW WALKER RD # 443, BEAVERTON, OR 97006-4942
(971) 224-6357
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L30018
OR
Other
Enumeration date
10/07/2019
Last updated
11/18/2024
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