Individual
DR. STACY JO HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4655 SW GRIFFITH DR STE 165, BEAVERTON, OR 97005-8731
(503) 646-8592
Mailing address
4655 SW GRIFFITH DR STE 165, BEAVERTON, OR 97005-8731
(503) 646-8592
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3548ATI
OR
152WP0200X
Pediatric Optometrist
3548ATI
OR
152WV0400X
Vision Therapy Optometrist
3548ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500673809
—
OR
Enumeration date
06/16/2014
Last updated
12/06/2019
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