Individual
JOSE MARIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
901 N BRUTSCHER ST STE E, NEWBERG, OR 97132
(803) 554-5555
(503) 538-1896
Mailing address
901 N BRUTSCHER ST STE E, NEWBERG, OR 97132
(803) 554-5555
(503) 538-1896
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2591ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150665
—
OR
Enumeration date
09/12/2006
Last updated
09/14/2010
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