OrganizationActive
East Side Orthotics & Prosthetics, Inc.
NPI 1386599421 · Prosthetic/Orthotic Supplier · Tualatin, OR
Provider details
- NPI number
- 1386599421
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Ivan Sabel, Ceo(503) 257-6623
Specialties & taxonomies
Suppliers
Practice location
19767 Sw 72nd Ave Ste 102
Tualatin, OR 97062-8354
Phone: (503) 257-6623
Fax: (503) 257-6624
Approximate (ZIP-level) locationGet directions
Mailing address
17316 Ne Halsey St
Portland, OR 97230-6026
Registry dates
- Enumerated
- 2026-03-03
- Last updated
- 2026-05-12
- Certified
- 2026-05-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.