Individual
SHAZIB HAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-3000
(503) 418-0843
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-3000
(503) 418-0843
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4619
OR
152WC0802X
Corneal and Contact Management Optometrist
ATI4619
OR
Other
Enumeration date
07/21/2021
Last updated
01/11/2024
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