Hiatt, Evan C

Hiatt, Evan C is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030-7514. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Hiatt, Evan C 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 / Addiction (Substance Use Disorder) 101YA0400X 20-CRM-280 Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 21-QMHA-R-1025 Oregon
Other Service Providers / Peer Specialist 175T00000X THW000104413 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X T-21-713 Oregon

Profile Details

NPI number 1689346769
LBN Legal business name Hiatt, Evan C
Credentials CADCR/CRM/PSS/QMHA-R
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2021
Last updated Mar 17th, 2022 - about 3 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 1689346769 NPPES
Oregon MEDICAID 500799772
Oregon MEDICAID 500799708

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