Organization
ESTACADA EYECARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMRITA KANG OD (PRESIDENT)
(503) 462-3811
Entity
Organization
Contact information
Practice address
405 NE MAIN ST, ESTACADA, OR 97023-8528
(503) 630-3528
Mailing address
PO BOX 358, ESTACADA, OR 97023-0358
(503) 630-3528
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508210139
—
OR
Enumeration date
01/31/2022
Last updated
11/19/2024
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