EVERCARE SUPPORT LLC NPI 1609737790

NPI Information

  • NPI: 1609737790
  • Provider Name: EVERCARE SUPPORT LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 1370 NW DIVISION ST
    GRESHAM, OR
    ZIP 97030
  • Phone: (206) 307-7941

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NPI Details

EVERCARE SUPPORT LLC is a psychiatric/mental health nurse practitioner in Gresham, OR. EVERCARE SUPPORT LLC NPI is 1609737790. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1370 NW DIVISION ST
GRESHAM, OR
ZIP 97030-350
Phone: (206) 307-7941

The provider's authorized official is Kidus Jalele .
The authorized official title is Adminstrator and has the following contact phone number (206) 307-7941.

The enumeration date for this NPI number is 11/19/2025 and was last updated on 11/19/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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