Evrard, Mary J

Evrard, Mary J is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030-7514. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Evrard, Mary J can be contacted via phone (971) 274-3757.

Contact Information

Primary practice address
620 Ne 2Nd St Gresham OR 97030-7514
Phone: (971) 274-3757
Fax: (503) 912-5740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X C4330 Oregon

Profile Details

NPI number 1740684190
LBN Legal business name Evrard, Mary J
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2014
Last updated Jun 1st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740684190 NPPES
Washington MEDICAID 2144708
Washington MEDICAID 500728251

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