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NPI Code Detail

MEDICARE: EVELIN VERMONT

MEDICARE: EVELIN VERMONT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1730039322
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELIN VERMONT
Provider Business Mailing Address
First Line : 18985 NW GREEN MOUNTAIN RD
Second Line :
City : BANKS
State : OR
Zip : 97106-7304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9670 SW BEAVERTON HILLSDALE HWY
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-3307
Country : US
Telephone Number : 971-229-4009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/21/2026

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Directions to “ EVELIN VERMONT ” Practice Location

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