Healthcare Provider Details

I. General information

NPI: 1891635892
Provider Name (Legal Business Name): EVERWELL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SW CENTURY DR APT 524
BEND OR
97702-3837
US

IV. Provider business mailing address

210 SW CENTURY DR APT 524
BEND OR
97702-3837
US

V. Phone/Fax

Practice location:
  • Phone: 541-748-3879
  • Fax: 541-581-8046
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JARED ANTHONY HEAD
Title or Position: FOUNDER / PHYSICIAN
Credential: MD
Phone: 541-696-3901