Provider Demographics
NPI:1275146920
Name:MCHUGH, DYLAN
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:MCHUGH
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 1:12442 SW SCHOLLS FERRY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-0803
Mailing Address - Country:US
Mailing Address - Phone:503-216-9280
Mailing Address - Fax:503-216-9284
Practice Address - Street 1:12442 SW SCHOLLS FERRY RD STE 202
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-0803
Practice Address - Country:US
Practice Address - Phone:503-216-9280
Practice Address - Fax:503-216-9284
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist