Basic Information
| Provider Information | |||||||||
| NPI: | 1780202952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE-EVANS | ||||||||
| FirstName: | CLAIRE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3030 100TH ST | ||||||||
| Address2: | |||||||||
| City: | URBANDALE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503223865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5154102908 | ||||||||
| FaxNumber: | 5154102909 | ||||||||
| Practice Location | |||||||||
| Address1: | 390 LINCOLN ST STE 230 | ||||||||
| Address2: | |||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974016021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412552095 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2020 | ||||||||
| LastUpdateDate: | 03/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 63678 | OR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.