Individual
DANE AGOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 NW MILLER AVE, GRESHAM, OR 97030-7225
(503) 665-3813
Mailing address
12976 SE 126TH AVE, HAPPY VALLEY, OR 97086-4363
(503) 780-7071
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4829
OR
Other
Enumeration date
07/06/2026
Last updated
07/06/2026
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