ANITA (ANNIE) PHROMSIVARAK BACON

PORTLAND, OR
NPI1366583684
Other NameANNIE PHROMSIVARAK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: OR  3195AT)
Enumeration Date2007-02-09
Last Update Date2013-05-21
Business Address
-- ANITA (ANNIE) PHROMSIVARAK BACON O.D.
921 SW 16TH AVE
PORTLAND, OR 97205-1730
Phone number: 503-227-0573
Mailing Address
-- ANITA (ANNIE) PHROMSIVARAK BACON O.D.
921 SW 16TH AVE
PORTLAND, OR 97205-1730
Phone number: 503-227-0573
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