Individual
DR. LAUREL GILLETTE MANNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1864 COLUMBIA BLVD, SAINT HELENS, OR 97051-1733
(503) 396-0928
(503) 397-7701
Mailing address
1864 COLUMBIA BLVD, SAINT HELENS, OR 97051-1733
(503) 396-0928
(503) 397-7701
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1442 ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127902
—
OR
Enumeration date
09/26/2006
Last updated
11/15/2007
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