| NPI | 1619445657 |
|---|---|
| Doing Business As | EVERGREEN PROSTHETICS AND ORTHOTICS |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L O'NEILL Owner 503-704-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2019-06-05 |