| NPI | 1275664625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM THOMAS SHULTS Member Owner 503-413-8032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD07886) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |