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EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
NPI 1063184141
Prosthetic/Orthotic Supplier in Vancouver, WA

Active since September 28, 2021
2121 NE 139TH ST, BLDG 1 STE 225, VANCOUVER, WA 98686(503) 765-5081 Get Directions Write a Review

NPPES record last updated: November 1, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 1, 2023, Sep 28, 2021 (2 updates tracked since 2021).

About Evergreen Prosthetics And Orthotics, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN PROSTHETICS AND ORTHOTICS, LLC (NPI 1063184141) is a healthcare organization registered as a prosthetic/orthotic supplier in Vancouver, Washington and active in the NPI registry since September 2021. The organization lists Tim O'neill, President, as its authorized official.

NPPES Registry Identity

NPI1063184141
Entity TypeOrganization
Primary Taxonomy335E00000X
Legal Business NameEVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Location Address2121 NE 139TH ST, BLDG 1 STE 225Vancouver, WA 98686-2316
Mailing Address911 Main St Ste 100Oregon City, OR 97045-1853 · (503) 765-5081 · Fax (971) 316-1553
Phone(503) 765-5081
Organization SubpartNo
Authorized OfficialTim O'neillPresident · (503) 407-5408
Enumeration DateSeptember 28, 2021
Last NPPES UpdateNovember 1, 20232 updates tracked since enumeration
NPPES CertifiedNovember 1, 2023
✔ NPI 1063184141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
Definition

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.

2121 NE 139TH ST, Vancouver, WA 98686
Open in Google Maps ↗

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Evergreen Prosthetics And Orthotics carries, from the Medicare DMEPOS supplier directory.

Evergreen Prosthetics And Orthotics

DMEPOS supplier · Vancouver, WAOperated by Evergreen Prosthetics And Orthotics LLC
⋮

Does not accept Medicare assignment

Evergreen Prosthetics And Orthotics has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20331755
Medicare Participant SinceJanuary 1, 2023
Supplier Location2121 NE 139th St Ste 225Vancouver, WA 98686
Phone(360) 322-3842
Supplier Specialties
Orthotic Personnel Prosthetic Personnel

Medicare Product Categories

Orthoses: Custom Fabricated
Custom met pads, Custom heel pads, Custom heel spur pads
Orthoses: Prefabricated (Non-Custom Fabricated)
Met pads, Heel pads, Heel spur pads
Orthoses: Off-The-Shelf
Met pads, Heel pads, Heel spur pads
Limb Prostheses
Prosthetic arms, Prosthetic feet, Prosthetic knees
Diabetic Shoes and Inserts
Shoes, Socks, Insoles
Diabetic Shoes/Inserts - Custom
Custom fabricated shoes, socks, & insoles
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARA SCHMITT PT
Speech-Language Pathologist
2121 NE 139TH ST
VANCOUVER, WA 98686
Clark County (360) 487-3750
MS. BROOKE LYNNE BERARD CCC-SLP
Speech-Language Pathologist
2121 NE 139TH ST, MEDICAL OFFICE BUILDING A, SUITE #200
VANCOUVER, WA 98686
Clark County (360) 487-1777
JILLIAN E. SHERRODD WING SLP
Speech-Language Pathologist
2121 NE 139TH ST, MOB A, STE 200
VANCOUVER, WA 98686
Clark County (360) 487-1777
TATIANA LVOVNA PETERSON MD
Internal Medicine
2121 NE 139TH ST
VANCOUVER, WA 98686
Clark County (360) 487-1000
KIMBERLY H. COPELAND MD
Pediatrics
2121 NE 139TH ST, SUITE 200
VANCOUVER, WA 98686
Clark County (360) 487-1777
AMBER D BURNETT SPT
Speech-Language Pathologist
2121 NE 139TH ST, MOB A SUITE 200
VANCOUVER, WA 98686
Clark County (360) 487-1777
KARA A CASSAR M.S. CCC-SLP
Speech-Language Pathologist
2121 NE 139TH ST, MOB A SUITE 200
VANCOUVER, WA 98686
Clark County (360) 487-1777
KIMBERLY GRIFFIN OTR/L
Occupational Therapist
2121 NE 139TH ST
VANCOUVER, WA 98686
Clark County (360) 487-1777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Prosthetics And Orthotics, LLC's NPI number?

The NPI number for Evergreen Prosthetics And Orthotics, LLC is 1063184141. It was assigned to this organization in the NPPES registry on September 28, 2021.

Where is Evergreen Prosthetics And Orthotics, LLC located?

Evergreen Prosthetics And Orthotics, LLC is located at 2121 NE 139th St Bldg 1 Ste 225, Vancouver, WA 98686. The listed phone number is (503) 765-5081.

What is Evergreen Prosthetics And Orthotics, LLC's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Does Evergreen Prosthetics And Orthotics, LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Evergreen Prosthetics And Orthotics does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

When was this NPI record last updated?

The NPPES record for Evergreen Prosthetics And Orthotics, LLC was last updated on November 1, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.