Organization
CASCADE OPTOMETRY,INC
Active
Other names
Cascade Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA LYNN KITCHENS O.D. (PRESIDENT)
(541) 378-0033
Entity
Organization
Contact information
Practice address
4141 NE STEPHENS ST, ROSEBURG, OR 97470-1161
(541) 378-0033
Mailing address
4141 NE STEPHENS ST, ROSEBURG, OR 97470-1161
(541) 378-0033
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3159 ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R155795
MEDICARE PTAN
OR
Enumeration date
12/04/2014
Last updated
12/04/2014
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