Provider Demographics
NPI:1659837458
Name:GALVIN, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:GALVIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 NW ISLAND CIR APT A2
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8523
Mailing Address - Country:US
Mailing Address - Phone:574-253-1564
Mailing Address - Fax:
Practice Address - Street 1:435 NW ISLAND CIR APT A2
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8523
Practice Address - Country:US
Practice Address - Phone:574-253-1564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty