Individual
DR. WALTER R. RECECONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
577 18TH ST, ASTORIA, OR 97103-3505
(503) 325-4401
(503) 325-3278
Mailing address
577 18TH ST, ASTORIA, OR 97103-3505
(503) 325-4401
(503) 325-3278
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2022ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150738
—
OR
Enumeration date
03/05/2007
Last updated
07/08/2007
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