# GLAUCOMA ASSOCIATES & CONSULTATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578584702
- **Authorized official:** MR. STEVEN L MANSBERGER MD MPH (OPTHALMOLOGIST)
- **Authorized official phone:** (503) 413-6453

## Contact information

- **Practice address:** 1040 NW 22ND AVE, SUITE 200, PORTLAND, OR 97210
- **Practice address phone:** (503) 413-8202
- **Practice address fax:** (503) 413-6937
- **Mailing address:** 1040 NW 22ND AVE, SUITE 200, PORTLAND, OR 97210
- **Mailing address phone:** (503) 413-8202
- **Mailing address fax:** (503) 413-6937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | MD22167 | OR | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 03/31/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 213408 | — | OR |