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Individual

GILBERT LE CREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
111 SE DOUGLAS ST, STE D, NEWPORT, OR 97365-4499
(541) 265-9458
(541) 265-6586
Mailing address
PO BOX 1367, NEWPORT, OR 97365-0106
(541) 265-9458
(541) 265-6586

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3015ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276456
OR
Enumeration date
01/15/2006
Last updated
05/13/2011
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