| NPI | 1184999377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS JOHNATHAN TAYLOR Owner 503-585-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: OR 3452ATI) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2021-07-08 |