| NPI | 1215073267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THELMA NEMARUNDWE Office Manager 503-285-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |