Individual
MRS. AYLA JADE HIMMELSBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7826 SW CAPITOL HWY, PORTLAND, OR 97219-2466
(503) 224-7788
Mailing address
7826 SW CAPITOL HWY, PORTLAND, OR 97219-2466
(503) 244-7788
(503) 244-2809
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3649ATI
OR
Other
Enumeration date
10/10/2012
Last updated
11/04/2021
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