Individual
ELI RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2804 19TH AVE, FOREST GROVE, OR 97116-2625
(503) 357-2020
(503) 357-6995
Mailing address
PO BOX 847, FOREST GROVE, OR 97116-0847
(503) 357-2020
(503) 357-6995
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3381ATI
OR
Other
Enumeration date
07/27/2010
Last updated
02/29/2012
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