Organization
DESCHUTES EYE CLINIC INC
Active
Other names
Eye Surgery Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLI TRAUSTASON M.D. (PRESIDENT)
(541) 548-7170
Entity
Organization
Contact information
Practice address
1775 SW UMATILLA AVE, REDMOND, OR 97756-7197
(541) 548-7170
(541) 548-3842
Mailing address
1775 SW UMATILLA AVE, REDMOND, OR 97756-7197
(541) 548-7170
(541) 548-3842
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071581
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138874101
BLUE CROSS PARTICIPATING
OR
05
—
165450
—
OR
01
—
180029258
UNITED HEALTHCARE RR
OR
01
—
490003253
RR MEDICARE
OR
Enumeration date
04/11/2007
Last updated
07/22/2020
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