| NPI | 1124466545 |
|---|---|
| Doing Business As | EYE DEPARTMENT |
| Entity Type | Organization |
| Authorized Contact | ANITA PHROMSIVARAK BACON Managing Member 503-227-0573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3195 ATI) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |