Organization
CASEY EYE PHYSICIANS AND SURGEONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTIE MARGARET BOWEN (CONTROLLER)
(503) 494-8423
Entity
Organization
Contact information
Practice address
3375 SW TERWILLINGER BLVD, PORTLAND, OR 97239
(503) 494-6107
(503) 494-0470
Mailing address
PO BOX 4183, PORTLAND, OR 97208
(360) 514-9060
(360) 514-9041
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165392
—
OR
01
—
CH3727
RAILROAD MEDICARE
—
Enumeration date
06/23/2006
Last updated
12/05/2007
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