Organization
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L O'NEILL CPO (PRESIDENT)
(503) 407-5408
Entity
Organization
Contact information
Practice address
1500 E HERITAGE PARK ST STE 100, MERIDIAN, ID 83646-5884
(208) 884-1294
(208) 884-1293
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
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/28/2020
Last updated
11/22/2023
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