Individual
DR. GEORGE RICHARD NELSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
611 SW BROADWAY, PORTLAND, OR 97205-3402
(503) 227-5949
(503) 227-3621
Mailing address
611 SW BROADWAY, PORTLAND, OR 97205-3402
(503) 227-5949
(503) 227-3621
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1189T
OR
Other
Enumeration date
08/23/2005
Last updated
07/08/2007
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