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Organization

CONVERGE NEURO OPTOMETRY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACSON LEE O.D. (CEO, OD, FOVDRA)
(650) 521-4570
Entity
Organization

Contact information

Practice address
9975 SW FREWING ST STE 130, TIGARD, OR 97223-5091
(503) 906-3596
(503) 906-1014
Mailing address
13010 SW CASPIAN CT, BEAVERTON, OR 97008-7760
(650) 521-4570

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
152WP0200X
Pediatric Optometrist
152WS0006X
Sports Vision Optometrist
152WV0400X
Vision Therapy Optometrist

Other

Enumeration date
11/18/2025
Last updated
11/18/2025
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