Organization
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Active
Parent organization
EVERGREEN PROSTHETICS & ORTHOTICS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN PROSTHETICS & ORTHOTICS, LLC
Authorized official
MS. TIMOTHY L O'NEILL (OWNER)
(503) 407-5408
Entity
Organization
Contact information
Practice address
1424 N MCDONALD RD, SUITE 201, SPOKANE VALLEY, WA 99216-6017
(509) 926-1403
(509) 926-1404
Mailing address
911 MAIN ST STE 100, OREGON CITY, OR 97045-1853
(503) 765-5081
(971) 315-1553
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/26/2015
Last updated
11/01/2023
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