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Organization
ST LUKES EYE CLINIC PC
Active
Organization
ST LUKES EYE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY ANN BETTS (OFFICE MANAGER)
(503) 698-2300
Entity
Organization
Contact information
Practice address
10365 SE SUNNYSIDE RD, SUITE 150, CLACKAMAS, OR 97015-5741
(503) 698-2300
(503) 698-2308
Mailing address
10365 SE SUNNYSIDE RD, SUITE 150, CLACKAMAS, OR 97015-5741
(503) 698-2300
(503) 698-2308
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35519
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067231
—
OR
01
—
20W00000X
TAXONOMY
OR
Enumeration date
12/03/2007
Last updated
12/03/2007
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