Individual
DR. KEIJI JAY SHIYOMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
61535 S HIGHWAY 97 STE 16, BEND, OR 97702-2156
(541) 389-4774
(541) 389-3971
Mailing address
61535 S HIGHWAY 97 STE 16, BEND, OR 97702-2156
(541) 389-4774
(541) 389-3971
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4607
OR
152WV0400X
Vision Therapy Optometrist
ATI4607
OR
Other
Enumeration date
01/11/2022
Last updated
02/15/2024
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