Organization
UPPER ECHELON FITNESS AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL WADE CREE DPT (OWNER/PHYSICAL THERAPIST)
(503) 501-8121
Entity
Organization
Contact information
Practice address
1420 NW 17TH AVE STE 388, PORTLAND, OR 97209-2447
(503) 501-8121
Mailing address
1420 NW 17TH AVE STE 388, PORTLAND, OR 97209-2447
(503) 501-8121
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3049
OR
225100000X
Physical Therapist
Primary
5776
OR
Other
Enumeration date
01/17/2013
Last updated
03/22/2013
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