Organization
WALDPORT EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN DEAN BLAIR OD (MEMBER)
(541) 563-4100
Entity
Organization
Contact information
Practice address
525 NW WILLOW, WALDPORT, OR 97394
(541) 563-4100
(541) 563-4468
Mailing address
PO BOX 888, WALDPORT, OR 97394-0888
(541) 563-4100
(541) 563-4468
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299057
—
OR
Enumeration date
08/05/2007
Last updated
03/13/2008
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