NPI 1003930132

Eyedentity Vision Center P.C.

Organisation Optometrist Portland, OR

Practice location

Address: 2609 SE Clinton St, Portland, OR 97202-1240
Phone: (503) 238-1139
Fax: (503) 235-6574

Authorised official

Name: Steven J Clouse
Title: President
Phone: (503) 238-1139

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2408T (OR)

Other Optometrist providers in Oregon →

Registry record

NPI: 1003930132
Entity type: Organization
NPI issued: 16 Mar 2007
Record last updated: 16 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.