Organization
CENTER FOR OCULAR PROSTHETICS LLC
Active
Other names
Christina Leitzel
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA N. LEITZEL BS, BCO, BADO (OCULARIST/OWNER)
(503) 229-8490
Entity
Organization
Contact information
Practice address
2456 NW NORTHRUP ST STE 1A, PORTLAND, OR 97210-3253
(503) 229-8490
(503) 224-0740
Mailing address
2456 NW NORTHRUP ST STE 1A, PORTLAND, OR 97210-3253
(503) 229-8490
(503) 224-0740
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
332BC3200X
Customized Equipment (DME)
51680289
OR
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
516802-89
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621900001
REGENCE BCBS DME SUPPLIER
OR
01
—
01758092-1
OREGON BUSINESS IDENTIFICATION NUMBER
OR
05
—
500647964
—
OR
Enumeration date
08/24/2011
Last updated
07/18/2023
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