Individual
MICHAEL DEEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4876 NW BETHANY BLVD, SUITE L-1, PORTLAND, OR 97229-9259
(503) 466-2254
(503) 466-1143
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5140
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028447
—
OR
Enumeration date
05/08/2006
Last updated
12/19/2016
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