| NPI | 1912386004 |
|---|---|
| Doing Business As | WILLAMETTE SPECTACLE SHOP |
| Entity Type | Organization |
| Authorized Contact | SUE STONEBURNER O PT Ician 541-683-3746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: OR 051837-85) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-29 |