Individual
EVAN ALEX HILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
12345 SW HORIZON BLVD STE 57, BEAVERTON, OR 97007-9475
(503) 216-8820
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60314
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500661778
—
OR
01
—
P01361145
RR MEDICARE
OR
Enumeration date
08/06/2013
Last updated
04/03/2019
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