1. Home
  2. Directory
  3. Oregon
  4. Coos Bay
  5. Peer Specialist
  6. NPI Profile

TABETHA LYNN EVERNDEN CRM
NPI 1215550934
Peer Specialist in Coos Bay, OR

Active since May 28, 2020
155 S EMPIRE BLVD, COOS BAY, OR 97420(541) 756-3111(541) 756-2111 Get Directions Write a Review

NPPES record last updated: May 28, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tabetha Lynn Evernden Crm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABETHA LYNN EVERNDEN CRM (NPI 1215550934) is an individual peer specialist in Coos Bay, Oregon, licensed in Oregon (20-CRM-114) and active in the NPI registry since May 2020. She maintains a secondary practice location in Coos Bay.

NPPES Registry Identity

NPI1215550934
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameTABETHA LYNN EVERNDENCredential: CRM
Location Address155 S EMPIRE BLVDCoos Bay, OR 97420-3374
Mailing Address1942 Sheridan AveNorth Bend, OR 97459-3416 · (541) 756-3111 · Fax (541) 756-2111
Phone(541) 756-3111
Fax(541) 756-2111
Sole ProprietorNo
Enumeration DateMay 28, 2020
NPPES CertifiedMay 28, 2020
✔ NPI 1215550934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · 20-CRM-114
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
155 S EMPIRE BLVD, Coos Bay, OR 97420
Open in Google Maps ↗

Secondary Practice Location 1

Location 11741 Newmark AveCoos Bay, OR 97420-4704 · Phone (541) 756-3111 · Fax (541) 756-2111

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH SUSAN TUCKER CRM
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 756-3111
JASON ALLEN PAUL PSS, CRM
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 756-3111
WILLIAM TODD STONE CRM
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 756-3111
KASSIE LIBBETT
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 796-8437
KELLY MARIE HERZOG
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 756-3111
TASHA ANNE WALTER CADC 1, CRM, PSS
Counselor (Addiction (Substance Use Disorder))
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 756-3111
REBECCA JEAN ALLDRIDGE
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 500-6223
RONNI WALTZ PSS
Peer Specialist
155 S EMPIRE BLVD
COOS BAY, OR 97420
Coos County (541) 756-3111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tabetha Evernden's NPI number?

The NPI number for Tabetha Evernden is 1215550934. It was assigned to this individual provider in the NPPES registry on May 28, 2020.

Where is Tabetha Evernden located?

Tabetha Evernden practices at 155 S Empire Blvd, Coos Bay, OR 97420. The listed phone number is (541) 756-3111.

What is Tabetha Evernden's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Tabetha Evernden was last updated on May 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.