Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evergreen Prosthetics and Orthotics, LLC

Organization Prosthetic/Orthotic Supplier · NPI 1619508702

Evergreen Prosthetics and Orthotics, LLC is a Prosthetic/Orthotic Supplier in Meridian, Idaho. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1500 E Heritage Park St Ste 100
Meridian, ID 83646-5884
Phone: (208) 884-1294
Fax: (208) 884-1293
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X

Record details

NPI number1619508702
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy O'Neill — President · (503) 407-5408
NPI enumeratedJanuary 28, 2020
Last updated in NPPESNovember 22, 2023
Certification dateNovember 22, 2023
Mailing address911 Main St Ste 100, Oregon City, OR 97045-1853

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