Organization
GRESHAM VISION CENTER, INC
Active
Parent organization
GRESHAM VISION CENTER
Other names
sandy vision center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRESHAM VISION CENTER
Authorized official
DIANE GARDNER (OFFICE MANAGER)
(503) 665-3813
Entity
Organization
Contact information
Practice address
39400 PIONEER BLVD STE 3, SANDY, OR 97055-8000
(503) 668-4313
(503) 668-5963
Mailing address
39400 PIONEER BLVD STE 3, SANDY, OR 97055-8000
(503) 668-4313
(503) 668-5963
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1627ATI
OR
152W00000X
Optometrist
2474ATI
OR
152W00000X
Optometrist
Primary
T67476
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022759
—
OR
Enumeration date
07/04/2006
Last updated
03/19/2015
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