| NPI | 1235325176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND K DEHAAN Optometrist/President 503-842-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2858T) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: OR 2858T) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: OR 2858T) | |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |