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Organization

EVOLUTION THERAPEUTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER MARIE MULCAHEY OT (OWNER)
(503) 956-6686
Entity
Organization

Contact information

Practice address
11930 SW GREENBURG RD, PORTLAND, OR 97223-6453
(503) 956-6686
Mailing address
11930 SW GREENBURG RD, PORTLAND, OR 97223-6453
(503) 956-6686

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1006876
OR

Other

Enumeration date
12/11/2009
Last updated
12/11/2009
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