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Individual

DR. LARRY E ROBERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
12100 SE STEVENS CT STE 106, PORTLAND, OR 97266-8707
(503) 653-1442
Mailing address
20279 DANNY CT, OREGON CITY, OR 97045-8618
(503) 655-1611

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1179
WA
152W00000X
Optometrist
Primary
1362ATI
OR

Other

Enumeration date
08/21/2006
Last updated
07/08/2007
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