Individual
DR. BRIAN MACMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12100 SE STEVENS CT STE 106, PORTLAND, OR 97086-4707
(503) 653-1442
Mailing address
12100 SE STEVENS CT STE 106, PORTLAND, OR 97086-4707
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1780ATI
OR
152W00000X
Optometrist
OD 00001663
WA
Other
Enumeration date
10/04/2006
Last updated
02/10/2022
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