Organization
EYEHEALTH NORTHWEST OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WELLS BENTLEY MD (OFFICER)
(503) 557-2020
Entity
Organization
Contact information
Practice address
11086 SE OAK ST, ADMINISTRATION, MILWAUKIE, OR 97222-6692
(503) 344-5102
(503) 344-5110
Mailing address
PO BOX 22009, MILWAUKIE, OR 97269-2009
(503) 344-5102
(503) 344-5110
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1243050001
DURABLE MEDICAL EQUIPMENT
OR
01
—
1243050002
DURABLE MEDICAL EQUIPMENT
OR
01
—
1243050003
DURABLE MEDICAL EQUIPMENT
OR
01
—
1243050004
DURABLE MEDICAL EQUIPMENT
OR
01
—
1243050005
DURABLE MEDICAL EQUIPMENT
OR
01
—
1243050006
DURABLE MEDICAL EQUIPMENT
OR
01
—
1243050007
DURABLE MEDICAL EQUIPMENT
OR
Enumeration date
04/17/2007
Last updated
09/17/2008
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