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Individual

DR. MICHAEL CONNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1260 LLOYD CTR, PORTLAND, OR 97232-1301
(503) 331-3984
Mailing address
2944 NW MODA WAY, APT. 723, HILLSBORO, OR 97124-7023

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3194
TN
152W00000X
Optometrist
Primary
3638ATI
OR

Other

Enumeration date
08/13/2014
Last updated
10/09/2015
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