Individual
TREVOR THOMAS PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
507 NE 47TH AVE, PORTLAND, OR 97213-2236
(503) 215-6488
Mailing address
507 NE 47TH AVE, PORTLAND, OR 97213-2236
(503) 215-6488
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
61193
OR
2251X0800X
Orthopedic Physical Therapist
61193
OR
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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