Individual
MADELINE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6300 SW NICOL RD, PORTLAND, OR 97223-7599
(503) 246-7771
Mailing address
7250 SW SHARON LN, PORTLAND, OR 97225-2057
(503) 703-4957
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10178388
OR
Other
Enumeration date
07/04/2018
Last updated
09/08/2022
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