Provider Demographics
NPI:1912418609
Name:OREGON ORTHOTIC SERVICES, INC
Entity Type:Organization
Organization Name:OREGON ORTHOTIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-971-7272
Mailing Address - Street 1:8880 SW NIMBUS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7111
Mailing Address - Country:US
Mailing Address - Phone:877-971-7272
Mailing Address - Fax:971-727-3162
Practice Address - Street 1:8880 SW NIMBUS AVE STE A
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7111
Practice Address - Country:US
Practice Address - Phone:877-971-7272
Practice Address - Fax:971-727-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies