Organization
WILLOW CREEK EYE CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAOLA F VITIELLO O.D (PRESIDENT)
(503) 645-8002
Entity
Organization
Contact information
Practice address
14740 NW CORNELL RD STE 110, PORTLAND, OR 97229-5400
(503) 645-8002
Mailing address
14740 NW CORNELL RD STE 110, PORTLAND, OR 97229-5400
(503) 645-8002
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2040ATI
OR
Other
Enumeration date
12/11/2012
Last updated
12/15/2012
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