Individual
DR. BRUCE FRANKLIN BRECKENRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
13140 NE HALSEY ST, PORTLAND, OR 97230-2350
(503) 253-7278
(503) 253-0279
Mailing address
13140 NE HALSEY ST, PORTLAND, OR 97230-2350
(503) 253-7278
(503) 253-0279
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2070T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020193
—
OR
01
—
300365203
FIRST CHOICE 65
OR
01
—
810438003
BLUE CROSS
OR
Enumeration date
03/31/2006
Last updated
05/29/2008
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