Individual
DR. WAYNE ROBERT PAULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
586 5TH ST STE 300, BROOKINGS, OR 97415-9720
(541) 469-7775
Mailing address
586 5TH ST STE 300, BROOKINGS, OR 97415-9720
(541) 469-7775
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1359ATI
OR
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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