Dr Bret A Provost, OD | |
9201 Se 91st Ave, Suite 210, Clackamas, OR 97086-3760 | |
(503) 775-2424 | |
(503) 775-6181 |
Full Name | Dr Bret A Provost |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 19 Years |
Location | 9201 Se 91st Ave, Clackamas, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528093556 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 3132 (Oregon) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
River City Eyecare, Llc | 5294874673 | 3 |
Provider Name | River City Eyecare, Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1578899472 PECOS PAC ID: 5294874673 Enrollment ID: O20091124000291 |
Mailing Address | Practice Location Address |
---|---|
Dr Bret A Provost, OD 9201 Se 91st Ave, Suite 210, Clackamas, OR 97086-3760 Ph: (503) 775-2424 | Dr Bret A Provost, OD 9201 Se 91st Ave, Suite 210, Clackamas, OR 97086-3760 Ph: (503) 775-2424 |
Derik Hardesty, OD Optometrist Medicare: Medicare Enrolled Practice Location: 12000 Se 82nd Ave, Clackamas, OR 97086 Phone: 503-659-5947 | |
Dr. Julia Sirianni, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 15259 Se 82nd Dr Ste 101, Clackamas, OR 97015 Phone: 503-657-0321 Fax: 503-657-7066 | |
Allie De La Cruz, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 15259 Se 82nd Dr Ste 101, Clackamas, OR 97015 Phone: 503-657-0321 | |
Jonathan Jay Attiyah, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 15259 Se 82nd Dr Ste 101, Clackamas, OR 97015 Phone: 503-657-0321 Fax: 503-657-7066 | |
Rachel A Jorgensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 15259 Se 82nd Dr Ste 101, Clackamas, OR 97015 Phone: 503-657-0321 | |
John William Reski, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 15259 Se 82nd Dr, Suite 101, Clackamas, OR 97015 Phone: 503-657-0321 Fax: 503-657-7066 | |
Mark Edward Mclain, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 12100 Se Stevens Ct Suite 106, Clackamas, OR 97086 Phone: 503-353-7269 |