OrganizationActive
Genesis Medical Group, LLC.
NPI 1457517138 · Prosthetic/Orthotic Supplier · Lake Oswego, OR
Provider details
- NPI number
- 1457517138
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Wyatt Brown, Director of Operation(503) 699-1911
- License
- 1355445-0 (OR)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
16679 Boones Ferry Rd Ste 215
Lake Oswego, OR 97035-4368
Phone: (503) 699-1911
Fax: (503) 699-1912
Street-level locationGet directions
Mailing address
16679 Boones Ferry Rd Ste 215
Lake Oswego, OR 97035-4368
Registry dates
- Enumerated
- 2008-08-01
- Last updated
- 2012-04-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.