Individual
DR. JACQUELYN M. DELPLANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
20 NW 185TH AVE, ALOHA, OR 97006-3507
(503) 629-5200
(503) 629-0419
Mailing address
20 NW 185TH AVE, ALOHA, OR 97006-3507
(503) 629-5200
(503) 629-0419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3024ATI
OR
152WP0200X
Pediatric Optometrist
3024ATI
OR
152WV0400X
Vision Therapy Optometrist
3024ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115639
OMAP
OR
01
—
R154528
MEDICARE PTAN
OR
Enumeration date
03/15/2007
Last updated
10/12/2010
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