Organization
PORTLAND OCULOPLASTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOT A SULLIVAN M.D. (PRESIDENT)
(503) 223-8333
Entity
Organization
Contact information
Practice address
10305 SW PARK WAY STE 203, PORTLAND, OR 97225-5033
(503) 223-8333
(503) 595-8160
Mailing address
10305 SW PARK WAY STE 203, PORTLAND, OR 97225-5033
(503) 223-8333
(503) 595-8160
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD21723
OR
Other
Enumeration date
12/22/2007
Last updated
10/06/2021
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