Individual
ALICE HAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(800) 813-2000
Mailing address
3600 N INTERSTATE AVE, CENTRAL INTERSTATE MEDICAL OFFICE OPTOMETRY, PORTLAND, OR 97227-1106
(503) 331-5121
(503) 249-5548
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
34653
CA
152W00000X
Optometrist
Primary
ATI4519
OR
152W00000X
Optometrist
OD61171189
WA
Other
Enumeration date
03/26/2020
Last updated
02/04/2022
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