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EVERGREEN PROSTHETICS AND ORTHOTICS, LLC

Suppliers Durable Medical Equipment & Medical Supplies

Provider NPI: 1003287269

Organization Information:
Organization Name:  EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Organization is not Subpart
Authorized Official:  TIMOTHY L O'NEILL  OWNER  503-407-5408

Practice Location:
501 N GRAHAM ST STE 255 PORTLAND, OR 97227-1654 US
Tel: 503-288-9929  Fax: 503-288-5904

Business Mailing Address:
8880 SW NIMBUS AVE STE A  BEAVERTON, OR 97008-7111 US
Tel: 877-971-7272  Fax: 971-727-3162

NPI Information:
NPI: 1003287269
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
Y335E00000XSuppliers
Prosthetic/Orthotic Supplier

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 335E00000X

Type:

Classification:



Definition:



MEDICAL JOBS OR - Page 1

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