Organization
STRATOS GROUP LLC
Active
Other names
Evolve Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WHITAKER MPT (OWNER)
(541) 550-7291
Entity
Organization
Contact information
Practice address
20510 SW ROY ROGERS RD STE 120, SHERWOOD, OR 97140-9320
(541) 550-7291
(541) 550-7356
Mailing address
20510 SW ROY ROGERS RD STE 120, SHERWOOD, OR 97140-9320
(541) 550-7291
(541) 550-7356
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61612
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61612
PT LICENSE
OR
Enumeration date
05/20/2013
Last updated
07/21/2022
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