| NPI | 1316367303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BERRY Owner 503-363-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2928ATI) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2020-01-27 |