Gresham Vision Center, INC

NPI #1619022076 in Gresham, Oregon

Provider Information

NPI Number: 1619022076
Entity Type: Organization
Organization Name: Gresham Vision Center, INC
Subpart: Yes (part of a larger organization)
Parent Organization: R104410
Primary Specialty: Optometrist
Enumeration Date: Jan 24, 2007
Last Updated: Mar 19, 2015

Practice Location

Address: 125 NW MILLER AVE
City: Gresham
State: Oregon
ZIP Code: 97030-7225
Phone: (503) 665-3813

Authorized Official

Name: DIANE GARDNER
Title: OFFICE MANAGER
Phone: (503) 665-3813

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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