OrganizationActive
Evergreen Prosthetics and Orthotics, LLC
NPI 1831218767 · Prosthetic/Orthotic Supplier · Gresham, OR
Provider details
- NPI number
- 1831218767
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Timothy O'Neill, Owner(503) 407-5408
- License
- 681350 (OR)
Specialties & taxonomies
Suppliers
Suppliers
Suppliers
Practice location
2850 Se Powell Valley Rd Ste 104
Gresham, OR 97080-1495
Phone: (503) 660-3180
Fax: (503) 660-3180
Approximate (ZIP-level) locationGet directions
Mailing address
911 Main St Ste 100
Oregon City, OR 97045-1853
Additional practice locations (1)
- 24076 Se Stark St Ste 320Gresham, OR 97030-3386Phone: (503) 242-9136Fax: (503) 242-9139
Registry dates
- Enumerated
- 2007-03-29
- 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.