| NPI | 1669856902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ROBERT WOJCIECHOWSKI Manager 503-657-0321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 1620ATI) |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy (Licence: OR 1620ATI) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-07-16 |