Individual
KEVIN RIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5050 NE HOYT ST STE 445, PORTLAND, OR 97213-2984
(503) 231-0166
(503) 231-2720
Mailing address
PO BOX 22009, PORTLAND, OR 97269-2009
(503) 558-7372
(503) 344-5140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3402ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500650374
—
OR
Enumeration date
10/07/2009
Last updated
06/20/2023
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