MEDICARE: EVELYN ALICE SVENDSEN

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	101Y00000X	Counselor	R12438	OR

General Provider Information

NPI Number	:	1588200141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN ALICE SVENDSEN

Provider Business Mailing Address
First Line	:	9133 N ALLEGHENY AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-2303
Country	:	US
Telephone Number	:	206-890-8045
Fax Number	:	503-662-6220

Provider Business Practice Location Address
First Line	:	9133 N ALLEGHENY AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-2303
Country	:	US
Telephone Number	:	206-890-8045
Fax Number	:	503-662-6220

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

Provider Enumeration Date	:	11/19/2019
Last Update Date	:	12/17/2025

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Directions to “ EVELYN ALICE SVENDSEN ” Practice Location

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