OrganizationActive
Evergreen Prosthetics and Orthotics, LLC
NPI 1619096005 · Prosthetic/Orthotic Supplier · Vancouver, WA
Provider details
- NPI number
- 1619096005
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Timothy O'Neill, Owner(503) 704-5408
- License
- 602608675 (WA)
Specialties & taxonomies
Suppliers
Suppliers
Suppliers
Practice location
8614 E Mill Plain Blvd Ste 110
Vancouver, WA 98664-2058
Phone: (360) 213-2088
Fax: (360) 213-0311
Approximate (ZIP-level) locationGet directions
Mailing address
911 Main St Ste 100
Oregon City, OR 97045-1853
Registry dates
- Enumerated
- 2007-03-28
- Last updated
- 2023-11-01
- Certified
- 2023-11-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.