Individual
SCOTT J WOJCIECHOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O D
Contact information
Practice address
6539 SE MILWAUKIE AVE, PORTLAND, OR 97202-5519
(503) 236-6008
(503) 236-2057
Mailing address
6539 SE MILWAUKIE AVE, PORTLAND, OR 97202-5519
(503) 236-6008
(503) 236-2057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OR1735AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R0000PHLBB
PTAN
OR
Enumeration date
05/24/2005
Last updated
01/27/2015
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