NPI 1003168337

Ayla Jade Himmelsbach, OD

Practitioner Optometrist Portland, OR

Practice location

Address: 7826 SW Capitol Hwy, Portland, OR 97219-2466
Phone: (503) 224-7788

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 3649ATI (OR)

Other Optometrist providers in Oregon →

Registry record

NPI: 1003168337
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Oct 2012
Record last updated: 4 Nov 2021

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.