OrganizationActive
Genesis Medical Group, LLC.
NPI 1740538115 · Prosthetic/Orthotic Supplier · Portland, OR
Provider details
- NPI number
- 1740538115
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Parent organization
- Genesis Medical Group, LLC.
- Organization subpart
- Yes
- Authorized official
- Wyatt Brown, Director of Operation(503) 699-1911
Specialties & taxonomies
Suppliers
Practice location
1515 Nw 18th Ave
Suite 100
Portland, OR 97209-2516
Phone: (503) 699-1911
Fax: (503) 699-1912
Approximate (ZIP-level) locationGet directions
Mailing address
16679 Boones Ferry Rd
Lake Oswego, OR 97035-4365
Registry dates
- Enumerated
- 2012-08-16
- Last updated
- 2012-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.