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Individual

KYRA EVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2701 NW VAUGHN ST STE 155, PORTLAND, OR 97210-5348
(503) 227-3479
(503) 223-4838
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60748
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0329717
WA L&I
OR
05
500675848
OR
Enumeration date
08/18/2014
Last updated
05/23/2016
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