| NPI | 1306988605 |
|---|---|
| Former Legal Business Name | GRESHAM STATION VISION INC |
| Entity Type | Organization |
| Authorized Contact | JOSEPH JUNGHO AN Principal 503-760-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR OR2825ATI) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2023-10-31 |