Eyedentity Vision Center P.c.

NPI 1003930132 - Optometrist - 152W00000X

NPI Details
NPI 1003930132
Enumeration Date 03/16/2007
Last Updated 10/16/2009
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name STEVEN J STEVEN
Position PRESIDENT
Phone (503) 238-1139
Fax (503) 235-6574
Practice Location
2609 SE CLINTON ST
PORTLAND OR, 97202-1240, US
Phone (503) 238-1139
Fax (503) 235-6574
Business Location
2609 SE CLINTON ST
PORTLAND OR, 97202-1240, US
Phone (503) 238-1139
Fax (503) 235-6574
Toxanomy
Taxonomy Code 152W00000X
License State Oregon
License Number 2408T
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According to our database, Eyedentity Vision Center P.c. NPI is 1003930132, taxonomy code is 152W00000X and license number is 2408T, license state is located at Oregon. Eyedentity Vision Center P.c. physically located at 2609 Se Clinton St, Portland OR, 97202-1240. NPI Number 1033115704 has the healthcare provider type.

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1003930132 NPI number is provided on an as is basis without warranty of any kind. 1003930132 is maintained by the National Plan & Provider Enumeration System. The contents of Eyedentity Vision Center P.c. are for informational purposes only.