Organization
KICK PERFORMANCE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN EVANS (PHYSICAL THERAPIST)
(806) 670-3481
Entity
Organization
Contact information
Practice address
EVOLUTION HEALTHCARE AND FITNESS, 905 SE ANKENY ST, PORTLAND, OR 97214
(971) 236-7610
Mailing address
949 NW OVERTON ST UNIT 1508, PORTLAND, OR 97209-3278
(806) 670-3481
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/21/2022
Last updated
08/05/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up