IndividualActive
Evan Gomez Villacorta
NPI 1831073774 · Mental Health Counselor · Fairview, OR
Provider details
- NPI number
- 1831073774
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1945 Ne 205th Ave
Fairview, OR 97024-9622
Phone: (503) 661-8050
Fax: (503) 492-4651
Approximate (ZIP-level) locationGet directions
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Registry dates
- Enumerated
- 2025-08-04
- Last updated
- 2025-08-04
- Certified
- 2025-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.