Organization
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM O'NEILL (PRESIDENT)
(503) 407-5408
Entity
Organization
Contact information
Practice address
5050 NE HOYT ST STE B50, PORTLAND, OR 97213-2957
(503) 467-4773
(503) 467-4775
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
06/16/2021
Last updated
11/01/2023
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