| NPI | 1578788014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN D WALLS Office Manager 503-581-7412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD10954) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 1604AT) |
| 152W00000X Optometrist (Licence: OR 3152ATI) | |
| 207W00000X Ophthalmology (Licence: OR MD26362) | |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OR MD10954) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-10-27 |