Healthcare Provider Details

I. General information

NPI: 1578973194
Provider Name (Legal Business Name): EVAN SPRAUER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N GRAHAM ST
PORTLAND OR
97227-1654
US

IV. Provider business mailing address

501 N GRAHAM ST
PORTLAND OR
97227-1654
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-2200
  • Fax:
Mailing address:
  • Phone: 503-413-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number5101022809
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: