Evergreen Pelvic Health and Wellness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

EVERGREEN PELVIC HEALTH AND WELLNESS LLC

Practice address

1001 SE Water Ave Ste 247
Portland, OR 97214-2148

Phone

(503) 270-3086

Fax

(971) 351-6651

NPI assigned

Apr 16, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emily Caldwell, DPTNPI 1891091385

Title

Owner

Phone

(303) 870-6611

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily Rust Caldwell, DPT

  • Physical Therapist
  • Portland, OR
  • NPI 1891091385
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720051200000",
    "number": "1043064959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 SE HAWTHORNE BLVD # 1025",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145048",
            "telephone_number": "503-270-3086",
            "fax_number": "971-351-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SE WATER AVE STE 247",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142148",
            "telephone_number": "503-270-3086",
            "fax_number": "971-351-6651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3439 SE Hawthorne Blvd # 1025",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972145048",
            "country_code": "US",
            "telephone_number": "503-270-3086",
            "fax_number": "971-351-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVERGREEN PELVIC HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-870-6611",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Evergreen Pharmaceutical LLC
• Evergreen Prosthetics and Orthotics, LLC
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• Evergreen Prosthetics and Orthotics, LLC
• Evergreen Prosthetics and Orthotics, LLC

• Physical Therapy Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapy Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.