Individual
MICHAEL ALAN BEVILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25030 SW PARKWAY AVE STE 200, WILSONVILLE, OR 97070-9816
(503) 612-0498
(503) 459-0521
Mailing address
25030 SW PARKWAY AVE STE 200, WILSONVILLE, OR 97070-9816
(503) 612-0498
(503) 459-0521
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD0000053944
TN
2085R0204X
Vascular & Interventional Radiology Physician
MD0000053944
TN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD194533
OR
Other
Enumeration date
04/22/2013
Last updated
05/07/2020
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