Individual
DR. ALEXANDRA BAVASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2043 COLLEGE WAY, FOREST GROVE, OR 97116-1756
(503) 352-2202
Mailing address
2043 COLLEGE WAY, FOREST GROVE, OR 97116-1756
(503) 352-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3630ATI
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/10/2012
Last updated
08/10/2015
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