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Individual

O. KEENE CLAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
22640 SE STARK ST, GRESHAM, OR 97030-2656
(503) 667-0441
(503) 666-6718
Mailing address
22640 SE STARK ST, GRESHAM, OR 97030-2656
(503) 667-0441
(503) 666-6718

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1223T
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143685
OR
Enumeration date
07/27/2006
Last updated
01/25/2011
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