| |
545 Sw Campus Dr., Suite 2531, Portland, OR 97239-3130 | |
(503) 494-3000 | |
(503) 494-0470 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 545 Sw Campus Dr., Portland, Oregon |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588748248 | NPI | - | NPPES |
288024 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
3375 Sw Terwilliger Blvd, Mail Code Cei, Portland, OR 97239-4146 Ph: (503) 494-3000 | 545 Sw Campus Dr., Suite 2531, Portland, OR 97239-3130 Ph: (503) 494-3000 |