Organization
DESCHUTES EYE CLINIC PC
Active
Other names
The Eye Surgery Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLI I TRAUSTASON M.D. (PRESIDENT)
(541) 548-7170
Entity
Organization
Contact information
Practice address
813 SW HIGHLAND AVE, REDMOND, OR 97756-3123
(541) 548-7170
(541) 548-3842
Mailing address
813 SW HIGHLAND AVE, REDMOND, OR 97756-3123
(541) 548-7170
(541) 548-3842
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053857000
REGENCE BCBS
OR
01
—
38080A
CLEAR CHOICE
OR
01
—
CJ8770
RAILROAD MEDICARE
OR
Enumeration date
08/17/2005
Last updated
12/01/2010
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