Healthcare Provider Details

I. General information

NPI: 1689400400
Provider Name (Legal Business Name): EVOLVE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SAINT ST
RICHLAND WA
99354-5301
US

IV. Provider business mailing address

1142 BELMONT BLVD
WEST RICHLAND WA
99353-7861
US

V. Phone/Fax

Practice location:
  • Phone: 509-219-0205
  • Fax:
Mailing address:
  • Phone: 509-521-8849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MORGAN GESE
Title or Position: OWNER
Credential: PT, DPT
Phone: 509-521-8849