Organization
EAST SIDE ORTHOTICS & PROSTHETICS, INC.
Active
Organization
EAST SIDE ORTHOTICS & PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN SABEL (CEO)
(503) 257-6623
Entity
Organization
Contact information
Practice address
19767 SW 72ND AVE STE 102, TUALATIN, OR 97062-8354
(503) 257-6623
(503) 257-6624
Mailing address
17316 NE HALSEY ST, PORTLAND, OR 97230-6026
(503) 257-6623
(503) 257-6624
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/03/2026
Last updated
05/12/2026
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