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Individual

DR. ROBERT DAVID PEEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
5045 SW 77TH AVE, PORTLAND, OR 97225-1812
(503) 297-1096
(503) 296-7240
Mailing address
5060 OAKRIDGE RD, LAKE OSWEGO, OR 97035-3312
(503) 635-7975

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1719AT
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
194712
OR
Enumeration date
10/24/2005
Last updated
03/02/2011
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