Organization
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM O'NEILL (PRESIDENT)
(503) 641-2020
Entity
Organization
Contact information
Practice address
501 N GRAHAM ST, STE 255, PORTLAND, OR 97227-1654
(503) 288-9929
(503) 288-5904
Mailing address
911 MAIN ST STE 100, OREGON CITY, OR 97045-1853
(503) 765-5081
(971) 316-1553
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/14/2015
Last updated
11/01/2023
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