Organization
BROADWAY VISION WORLD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMELIA MASSIH OD (CEO)
(503) 223-6655
Entity
Organization
Contact information
Practice address
1962 SW BROADWAY, PORTLAND, OR 97201-6710
(503) 223-6655
(503) 233-6657
Mailing address
PO BOX 108, BEAVERTON, OR 97075-0108
(503) 223-6655
(503) 223-6657
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1863T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013354
—
OR
Enumeration date
11/13/2007
Last updated
11/13/2007
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