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Individual

OWEN SILAS MCILHATTAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4704 SE HAWTHORNE BLVD, PORTLAND, OR 97215-3250
(503) 235-6639
Mailing address
24719 SE RUGG RD, GRESHAM, OR 97080-7353
(503) 334-7560

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4465
OR
152W00000X
Optometrist
OD60966063
WA

Other

Enumeration date
08/19/2019
Last updated
08/19/2019
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