Individual
KYLE PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15480 BOONES FERRY RD, LAKE OSWEGO, OR 97035-3429
(503) 635-1458
Mailing address
15480 BOONES FERRY RD, LAKE OSWEGO, OR 97035-3429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3659ATI
OR
Other
Enumeration date
06/13/2016
Last updated
08/25/2016
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