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NPI Code Detail

MEDICARE: REBECCA EVANS MAC, CDPT, CADCIII,

MEDICARE: REBECCA EVANS MAC, CDPT, CADCIII,
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
1101YA0400XAddiction (Substance Use Disorder) Counselor60691835WA
2101YA0400XAddiction (Substance Use Disorder) Counselor16-01-03OR
3101YA0400XAddiction (Substance Use Disorder) Counselor511732OR
4175T00000XPeer Specialist25-CRM-4605OR
5101YA0400XAddiction (Substance Use Disorder) Counselor17-04-24OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117-04-24OTHEROROREGON ADDICTION COUNSELOR CERTIFICATION BOARD
2511732OTHERORNAADAC

General Provider Information

NPI Number : 1629504865
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA EVANS MAC, CDPT, CADCIII,
Provider Business Mailing Address
First Line : 1010 5TH ST
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-2444
Country : US
Telephone Number : 503-954-1890
Fax Number :
Provider Business Practice Location Address
First Line : 1010 5TH ST
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-2444
Country : US
Telephone Number : 503-954-1890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2017
Last Update Date : 07/16/2025

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