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KEVIN SHANK
NPI 1760867659
Counselor - Addiction (Substance Use Disorder) in Portland, OR

Active since July 21, 2015PECOS Enrolled
33 NW BROADWAY, PORTLAND, OR 97209(503) 944-4410 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 1, 2025, Nov 1, 2019 (2 updates tracked since 2019).

About Kevin Shank NPPES

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

KEVIN SHANK (NPI 1760867659) is an individual addiction (substance use disorder) provider in Portland, Oregon, licensed in Oregon (23-11-30089) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760867659
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameKEVIN SHANK
Location Address33 NW BROADWAYPortland, OR 97209-3580
Mailing Address10759 Sw Heron CirBeaverton, OR 97007-8353
Phone(503) 944-4410
Sole ProprietorNo
Enumeration DateJuly 21, 2015
Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1760867659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OR · 23-11-30089
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License L17410 (OR)
33 NW BROADWAY, Portland, OR 97209
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Shank is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

JEFFREY M MOORE LPC, CADC I
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
SAMANTHA DUFFARD
Peer Specialist
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
DAVID CROUSE
Counselor (Addiction (Substance Use Disorder))
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
KAELI HARWOOD LCSW
Social Worker (Clinical)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
AUBREY ALVARADO
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
PHILIP JOHN DEGRAFFENREID
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
MR. JEREMY HUTSON RN
Registered Nurse
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
KYLE STILWELL
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134

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 Kevin Shank's NPI number?

The NPI number for Kevin Shank is 1760867659. It was assigned to this individual provider in the NPPES registry on July 21, 2015.

Where is Kevin Shank located?

Kevin Shank practices at 33 NW Broadway, Portland, OR 97209. The listed phone number is (503) 944-4410.

What is Kevin Shank's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Kevin Shank enrolled in Medicare?

Yes. Kevin Shank is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Shank was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.