| NPI | 1154452894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RANDOLPH President, O PT Ometrist 503-363-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 1453ATI ACTIVE) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |