Organization
EYE HEALTH EASTSIDE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT WILLIAMS (CEO)
(503) 344-5101
Entity
Organization
Contact information
Practice address
12050 SE STEVENS RD STE 400, PORTLAND, OR 97086-7667
(971) 206-6100
(971) 206-6103
Mailing address
PO BOX 220059, MILWAUKIE, OR 97269-0059
(503) 558-7372
(503) 344-5140
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
07-1553
OR
261QS0132X
Ophthalmologic Surgery Clinic/Center
07-1553
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275034
—
OR
Enumeration date
11/07/2005
Last updated
04/05/2022
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