Provider Demographics
NPI:1083334213
Name:MCLEAN, EVELYN CHRISTINE (CADC-R)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:CHRISTINE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:CHRISTINE
Other - Last Name:MCLEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 NE ROSA PARKS WAY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-3021
Mailing Address - Country:US
Mailing Address - Phone:310-913-5338
Mailing Address - Fax:
Practice Address - Street 1:3311 NE MLK BLVD STE 104
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-2086
Practice Address - Country:US
Practice Address - Phone:503-206-8856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical