| NPI | 1134494198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA LYNN PINSKE BACKUS Optometrist 503-516-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60276428) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2015-09-03 |