| |
1020 Liberty St Se, Salem, OR 97302-4141 | |
(503) 581-7412 | |
(503) 581-1095 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1020 Liberty St Se, Salem, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346339843 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1604T (Oregon) | Primary |
152W00000X | Optometrist | 3152ATI (Oregon) | Primary |
207W00000X | Ophthalmology | MD10954 (Oregon) | Primary |
Mailing Address | Practice Location Address |
---|---|
1020 Liberty St Se, Salem, OR 97302-4141 Ph: (503) 581-7412 | 1020 Liberty St Se, Salem, OR 97302-4141 Ph: (503) 581-7412 |