Individual
MR. AMAND STEPHEN TASRIPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12923 NW CORNELL RD STE 203, PORTLAND, OR 97229-5834
(503) 645-5076
Mailing address
12923 NW CORNELL RD STE 203, PORTLAND, OR 97229-5834
(503) 645-5076
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI3577
OR
Other
Enumeration date
10/19/2011
Last updated
03/01/2022
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