MEDICARE: AMPHORA HEALTH GROUP LLC

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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1558220004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMPHORA HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	50 W SHORE CT
Second Line	:
City	:	STEILACOOM
State	:	WA
Zip	:	98388-1732
Country	:	US
Telephone Number	:	360-349-6382
Fax Number	:	360-349-6382

Provider Business Practice Location Address
First Line	:	50 W SHORE CT
Second Line	:
City	:	STEILACOOM
State	:	WA
Zip	:	98388-1732
Country	:	US
Telephone Number	:	360-349-6382
Fax Number	:	360-349-6382

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	EVAN HASSEL
Credential	:	DPT
Telephone Number	:	360-349-6382

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “AMPHORA HEALTH GROUP LLC ” Practice Location

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