Susannah Lee Eye Care | |
11425 Sw Beaverton Hillsdale Hwy, Beaverton, OR 97005-3050 | |
(503) 643-5590 | |
(503) 643-2266 |
Full Name | Susannah Lee Eye Care |
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Type | Facility |
Speciality | Optometrist |
Location | 11425 Sw Beaverton Hillsdale Hwy, Beaverton, Oregon |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093215949 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Susannah Lee |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1558747576 PECOS PAC ID: 3173884814 Enrollment ID: I20220608002462 |
Mailing Address | Practice Location Address |
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Susannah Lee Eye Care 1830 Nw Riverscape St Apt 504, Portland, OR 97209-1840 Ph: () - | Susannah Lee Eye Care 11425 Sw Beaverton Hillsdale Hwy, Beaverton, OR 97005-3050 Ph: (503) 643-5590 |
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