Individual
PHILIP A. DEVASTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
16679 BOONES FERRY RD STE 105, LAKE OSWEGO, OR 97035-4378
(503) 635-6005
Mailing address
4817 SW HUMPHREY PARK CRST, PORTLAND, OR 97221-2333
(617) 365-1527
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4081
OR
Other
Enumeration date
01/28/2011
Last updated
11/15/2023
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