Individual
SHARI L MACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4035 MERCANTILE DR, SUITE 216, LAKE OSWEGO, OR 97035-2546
(503) 636-2551
(503) 636-3055
Mailing address
6420 SW MACADAM AVE, SUITE 216, PORTLAND, OR 97239-3507
(503) 244-8601
(503) 244-3013
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1928AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226335
—
OR
01
—
410043877
RAILROAD MEDICARE
OR
Enumeration date
11/30/2005
Last updated
05/29/2013
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