Provider Demographics
NPI:1922202837
Name:EVERCARE
Entity Type:Organization
Organization Name:EVERCARE
Other - Org Name:UNITED HEALTH GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:NETWORK OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-746-0059
Mailing Address - Street 1:5 CENTERPOINTE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8662
Mailing Address - Country:US
Mailing Address - Phone:800-718-1259
Mailing Address - Fax:
Practice Address - Street 1:5 CENTERPOINTE DR STE 600
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8662
Practice Address - Country:US
Practice Address - Phone:800-718-1259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR080045295N3 ANP-PP305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization