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Individual

CHRISTOPHER CARMIENCKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
452 NE GREENWOOD AVE, BEND, OR 97701-4645
(541) 382-5701
(541) 382-5702
Mailing address
452 NE GREENWOOD AVE, BEND, OR 97701-1134
(541) 382-5701
(541) 382-5702

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1221 ATI
OR
152WV0400X
Vision Therapy Optometrist
1221 ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03256-5
OR
Enumeration date
01/02/2007
Last updated
09/21/2017
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