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Individual

BRUCE ROBERT WOJCIECHOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
15259 SE 82ND DR, SUITE 101, CLACKAMAS, OR 97015-6609
(503) 657-0321
(503) 657-7066
Mailing address
15259 SE 82ND DR, SUITE 101, CLACKAMAS, OR 97015-6609
(503) 657-0321
(503) 657-7066

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1620ATI
OR
152W00000X
Optometrist
OD00001458
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
282442
OR
Enumeration date
10/11/2006
Last updated
07/17/2012
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