MEDICARE: DR. MORGAN DANEEL EVANS D.O

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
1	207Q00000X	Family Medicine Physician	OP60538018	WA
2	207Q00000X	Family Medicine Physician	DO221735	OR
3	207Q00000X	Family Medicine Physician	0116025188	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053666081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MORGAN DANEEL EVANS D.O

Provider Business Mailing Address
First Line	:	500 NE MULTNOMAH ST STE 100
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2031
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 7TH AVE
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-3198
Country	:	US
Telephone Number	:	800-813-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2012
Last Update Date	:	03/05/2026

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