# EVERGREEN PELVIC HEALTH AND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043064959
- **Authorized official:** EMILY CALDWELL DPT (OWNER)
- **Authorized official phone:** (303) 870-6611

## Contact information

- **Practice address:** 1001 SE WATER AVE STE 247, PORTLAND, OR 97214-2148
- **Practice address phone:** (503) 270-3086
- **Practice address fax:** (971) 351-6651
- **Mailing address:** 3439 SE HAWTHORNE BLVD \# 1025, PORTLAND, OR 97214-5048
- **Mailing address phone:** (503) 270-3086
- **Mailing address fax:** (971) 351-6651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/16/2024
- **Last updated:** 07/04/2024