Portland Oculoplastics, PC

NPI #1316121692 in Portland, Oregon

Provider Information

NPI Number: 1316121692
Entity Type: Organization
Organization Name: Portland Oculoplastics, PC
Primary Specialty: Ophthalmology
Enumeration Date: Dec 22, 2007
Last Updated: Oct 6, 2021

Practice Location

Address: 10305 SW PARK WAY STE 203
City: Portland
State: Oregon
ZIP Code: 97225-5033
Phone: (503) 223-8333

Authorized Official

Name: DR. SCOT A SULLIVAN, M.D.
Title: PRESIDENT
Phone: (503) 223-8333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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