Individual
DR. EVAN THEODORE SAULINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4104 SE 82ND AVE, SUITE 250, PORTLAND, OR 97266-2954
(503) 215-9850
(503) 215-9855
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD24603
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232848
—
OR
01
—
P00630516
RR MEDICARE- PROVIDENCE
OR
Enumeration date
09/13/2006
Last updated
03/24/2021
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