| Evolution Therapeutics Llc | |
|
11930 Sw Greenburg Rd Portland OR 97223-6453 | |
| (503) 956-6686 | |
| Not Available |
| Full Name | Evolution Therapeutics Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 11930 Sw Greenburg Rd, Portland, Oregon |
| Authorized Official Name and Position | Heather Marie Mulcahey (OWNER) |
| Authorized Official Contact | 5039566686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Therapeutics Llc 11930 Sw Greenburg Rd Portland OR 97223-6453 Ph: (503) 956-6686 | Evolution Therapeutics Llc 11930 Sw Greenburg Rd Portland OR 97223-6453 Ph: (503) 956-6686 |
| NPI Number | 1346579869 |
|---|---|
| Provider Enumeration Date | 12/11/2009 |
| Last Update Date | 12/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346579869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1006876 (Oregon) | Primary |
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