MEDICARE: EVAN KLEIN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA227917	OR

General Provider Information

NPI Number	:	1184465130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVAN KLEIN PA-C

Provider Business Mailing Address
First Line	:	2730 S MOODY AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-5042
Country	:	US
Telephone Number	:	503-494-3633
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 NE 48TH AVE STE 1100
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97124-5062
Country	:	US
Telephone Number	:	503-844-8219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2024
Last Update Date	:	03/17/2026

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Directions to “ EVAN KLEIN PA-C” Practice Location

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