Individual
KYLE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9565 SW FREWING CT, TIGARD, OR 97223-6029
(503) 880-6002
Mailing address
9565 SW FREWING CT, TIGARD, OR 97223-6029
(503) 880-6002
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26459
OR
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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