Individual
MICHAEL CRAIG COLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
19255 SW 65TH AVE, STE. 120, TUALATIN, OR 97062-7451
(503) 692-4934
(503) 691-9655
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6240
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500637032
—
OR
01
—
P01152128
RR MEDICARE
OR
Enumeration date
06/11/2010
Last updated
04/30/2013
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