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General NPI Number Information
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NPI Number | 1619445657
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Entity Type | Organization
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Legal Business Name | OREGON ORTHOTIC SERVICES
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 8880 SW NIMBUS AVE STE A
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City | BEAVERTON
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State | OR
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Zip | 97008-7111
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Country | US
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Telephone | 877-971-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 8880 SW NIMBUS AVE STE A
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City | BEAVERTON
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State | OR
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Zip | 97008-7111
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Country | US
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Telephone | 877-971-7272
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY L O'NEILL
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Credential |
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Telephone | 503-704-5408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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