Travis Pack Lafayette, OD

NPI #1871606293 in Portland, Oregon

Provider Information

NPI Number: 1871606293
Entity Type: Individual
Name: Travis Pack Lafayette, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Aug 17, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 19500 SE STARK ST
City: Portland
State: Oregon
ZIP Code: 97233-5757
Phone: (503) 669-3900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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