Organization
OREGON ORTHOTIC SERVICES
Active
Other names
Evergreen Prosthetics and Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L O'NEILL (OWNER)
(503) 704-5408
Entity
Organization
Contact information
Practice address
8880 SW NIMBUS AVE STE A, BEAVERTON, OR 97008-7111
(877) 971-7272
Mailing address
8880 SW NIMBUS AVE STE A, BEAVERTON, OR 97008-7111
(877) 971-7272
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27475
—
OR
Enumeration date
11/07/2018
Last updated
06/05/2019
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