Evergreen Prosthetics and Orthotics, LLC
NPI #1063184141 in Vancouver, Washington
Provider Information
- NPI Number
- 1063184141
- Entity Type
- Organization
- Organization Name
- Evergreen Prosthetics and Orthotics, LLC
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Sep 28, 2021
- Last Updated
- Nov 1, 2023
Practice Location
- Address
- 2121 NE 139TH ST
- Address 2
- BLDG 1 STE 225
- City
- Vancouver
- State
- Washington
- ZIP Code
- 98686-2316
- Phone
- (503) 765-5081
Authorized Official
- Name
- TIM O'NEILL, CPO
- Title
- PRESIDENT
- Phone
- (503) 407-5408
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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