OrganizationActive
Evergreen Prosthetics and Orthotics, LLC
NPI 1952767485 · Prosthetic/Orthotic Supplier · Portland, OR
Provider details
- NPI number
- 1952767485
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Timothy O'Neill, Owner(503) 407-5408
Specialties & taxonomies
Suppliers
Suppliers
Practice location
149 Ne 102nd Ave
Portland, OR 97220-4168
Phone: (503) 208-3699
Fax: (503) 208-2210
Approximate (ZIP-level) locationGet directions
Mailing address
911 Main St Ste 100
Oregon City, OR 97045-1853
Registry dates
- Enumerated
- 2016-01-13
- 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.