NPI 1013022664

Larry E Robertson, OD

Practitioner Optometrist Portland, OR

Practice location

Address: 12100 SE Stevens CT STE 106, Portland, OR 97266-8707
Phone: (503) 653-1442
Mailing address: 20279 Danny CT, Oregon City, OR 97045-8618

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1362ATI (OR)

Other Optometrist providers in Oregon →

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1179 (WA)

Registry record

NPI: 1013022664
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Aug 2006
Record last updated: 8 Jul 2007

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.