Healthcare Provider Details

I. General information

NPI: 1780202952
Provider Name (Legal Business Name): CLAIRE LEE-EVANS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 LINCOLN ST STE 230
EUGENE OR
97401-6021
US

IV. Provider business mailing address

3030 100TH ST
URBANDALE IA
50322-3865
US

V. Phone/Fax

Practice location:
  • Phone: 541-255-2095
  • Fax:
Mailing address:
  • Phone: 515-410-2908
  • Fax: 515-410-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number63678
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: