Individual
DR. RICHARD WALTER ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4441 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6271
(503) 775-4550
(503) 775-3208
Mailing address
4441 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6271
(503) 775-4550
(503) 775-3208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2025T
OR
Other
Enumeration date
10/16/2006
Last updated
11/27/2007
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