EVERGREEN PROSTHETICS AND ORTHOTICS, LLC (NPI# 1659813657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659813657 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PROSTHETICS AND ORTHOTICS, LLC |
| Practice Address |
1555 3rd Ave Ste B Longview WA 98632-3268 |
| Mailing Address |
8880 Sw Nimbus Ave Ste A Beaverton OR 97008-7111 |
| Practice Telephone | 3602328525 |
| Practice Fax Number | 3602328633 |
| Mailing Telephone | 8779717272 |
| Mailing Fax Number | 9717273162 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2020-02-11 |
| Authorized Official Name | TIMOTHY L O'NEILL (OWNER) |
| Authorized Official Telephone | 5034075408 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619508702 | Evergreen Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 1500 E Heritage Park St Ste 100, Meridian, ID 83646-5884 | 2020-01-28 |
| 1023503497 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 1818 S 10th Ave Ste 240, Caldwell, ID 83605-4880 | 2018-06-27 |
| 1811269129 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 911 Main St Ste 120, Oregon City, OR 97045-1867 | 2012-02-01 |
| 1831218767 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 1940 Nw 24th Ave, Portland, OR 97210-2786 | 2007-03-29 |
| 1619096005 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 11201 Ne 9th St, Suite 100, Vancouver, WA 98684 | 2007-03-28 |
| 1821037284 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 862 Se Oak St Ste 2b, Hillsboro, OR 97123-4240 | 2006-06-04 |
| 1831739127 | Evergreen Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 24076 Se Stark St Ste 320, Gresham, OR 97030-3386 | 2020-01-14 |
| 1922662865 | Evergreen Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 425 S Whitley Dr Ste 431, Fruitland, ID 83619-2611 | 2019-04-25 |
| 1407300338 | Evergreen Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 1940 Nw 24th Ave, Portland, OR 97210-2786 | 2016-08-09 |
| 1235595760 | Evergreen Prosthetics and Orthotics, LLC | Durable Medical Equipment & Medical Supplies | 2120 Exchange St, Suite 204, Astoria, OR 97103-3365 | 2016-01-13 |
| Street Address |
1555 3RD AVE STE B |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-3268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932429974 | David H Stuart | Orthotist | 1555 3rd Ave Ste B, Longview, WA 98632-3268 | 2010-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326290248 | Genesis Medical Group, LLC. | Prosthetic/Orthotic Supplier | 1338 Commerce Ave Ste D, Longview, WA 98632-3743 | 2008-10-22 |
| 1184822793 | Steven G Mccullough and David W Holt Orthotics & Prosthetics, LLC | Prosthetic/Orthotic Supplier | 422 N Green St, Longview, TX 75601-6458 | 2007-07-05 |
| 1447344296 | Ava Inc. | Prosthetic/Orthotic Supplier | 1113 Vandercook Way, Suite 120, Longview, WA 98632-4024 | 2006-10-03 |
| 1750323713 | Edgar De La Fuente | Prosthetic/Orthotic Supplier | 719 N. Second Street, Longview, TX 75601-5316 | 2006-06-12 |
| 1740720366 | Hanger Clinic | Prosthetic/Orthotic Supplier | 1516 Hudson St, Suite 105, Longview, WA 98632-3083 | 2017-03-01 |
| 1629379490 | Steven Glenn Mccullough | Prosthetic/Orthotic Supplier | 422 N Green St, Longview, TX 75601-6458 | 2010-11-10 |
| 1992934053 | Prosthetic-orthotic Associates of East Texas, Inc. | Prosthetic/Orthotic Supplier | 414 E Loop 281, Suite 20, Longview, TX 75605-7930 | 2009-07-10 |
| 1508048984 | East Texas Prosthetic-orthotic Care | Prosthetic/Orthotic Supplier | 812 N 4th St, Longview, TX 75601-5413 | 2007-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317784 | Preferred Orthotic and Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 520 S Cowley St Ste 104, Spokane, WA 99202-1315 | 2019-10-10 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1063906295 | Wmc Inc | Prosthetic/Orthotic Supplier | 2600 3rd Ave Ste B, Seattle, WA 98121-1293 | 2018-06-20 |
| 1174934707 | Nw Magnum LLC | Prosthetic/Orthotic Supplier | 108 Central Way, Kirkland, WA 98033-6106 | 2014-05-16 |
| 1205100013 | Cadence Biomedical, Inc. | Prosthetic/Orthotic Supplier | 146 N Canal St Ste 100, Seattle, WA 98103-8652 | 2012-02-27 |
| 1174807853 | Dental Sleep Therapy of Walla Walla Pllc | Prosthetic/Orthotic Supplier | 213 S 2nd Ave, Walla Walla, WA 99362-3002 | 2011-09-29 |
| 1922396159 | Hair Options | Prosthetic/Orthotic Supplier | 7106 Greenwood Ave N, Seattle, WA 98103-5038 | 2011-07-21 |
| 1083902746 | Seattle Cancer Care Alliance | Prosthetic/Orthotic Supplier | 207 Pontius Ave N, Suite 101, Seattle, WA 98109-5650 | 2011-07-15 |
| 1457645426 | Rcm Enterprise, LLC | Prosthetic/Orthotic Supplier | 8526 Delphi Rd Sw, Olympia, WA 98512-9349 | 2011-06-07 |
| 1417255019 | Beauty N Kurves LLC | Prosthetic/Orthotic Supplier | 513 1st Ave W, Seattle, WA 98119-3925 | 2011-03-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.