| NPI | 1346658960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TRAN Office Manager 503-705-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3306 ATI) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2022-11-29 |