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Individual

BRUCE WAYNE PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
19500 SE STARK ST, ROCKWOO MEDICAL OFFICE, PORTLAND, OR 97233-5757
(503) 669-3900
Mailing address
3460 N HOLLY ST, CANBY, OR 97013-8136
(503) 266-6355

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OR 1450T
OR
152W00000X
Optometrist
WA OD 00001253
WA

Other

Enumeration date
08/14/2006
Last updated
07/08/2007
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