Individual
EVAN J MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2200 NE NEFF RD, SUITE 202, BEND, OR 97701-4283
(541) 388-7738
(541) 312-0121
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
21406
MA
225100000X
Physical Therapist
Primary
5569
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0349708
WA L&I
OR
05
—
500697927
—
OR
Enumeration date
04/10/2007
Last updated
03/01/2016
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