Evolution Healthcare, Rehab., & Fitness

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

3851 Issued in OR

Legal business name

EVOLUTION HEALTHCARE, REHAB., & FITNESS

Doing business as

Evolution Healthcare

Practice address

2332 NW Irving St
Portland, OR 97210-3225

Phone

(503) 222-1865

NPI assigned

Jul 14, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brad Farra, DC

Title

Owner

Phone

(503) 975-6566

Specialties & licenses 1

Addresses

Other names 1

• Evolution Healthcare Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1730596511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4279 SE HARVEY ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972225816",
            "telephone_number": "503-975-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 NW IRVING ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103225",
            "telephone_number": "503-222-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION HEALTHCARE, REHAB., & FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "FARRA",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-975-6566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "3851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolution Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Eves
• Christopher Eves, MA
• Traci E Eveson
• Evgeny I Fedotov (north west clinical laboratory)
• Evoke Therapy LLC
• Evolution Therapeutics LLC
• Evolve and Elevate, LLC
• Evolve Wellness
• Evolving Self Integral Counseling, LLC (Evolving Self Integral Counseling)
• Collette Marie Evrard, NP

• Primary Care Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.