Organization
NORTHWEST OPTOMETRIC ASSOCIATES INC
Active
Other names
ABC Vision Source Hillsdale
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARI WARD OD (PRESIDENT)
(503) 473-8039
Entity
Organization
Contact information
Practice address
1522 SW SUNSET BLVD, PORTLAND, OR 97239-2626
(503) 473-8039
(503) 473-8952
Mailing address
1522 SW SUNSET BLVD, PORTLAND, OR 97239-2626
(503) 473-8039
(503) 473-8952
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2151ATI
OR
152W00000X
Optometrist
Primary
3023ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164622288
NPI OF SHERWOOD LOCATION UNDER SAME TAX ID
OR
Enumeration date
01/16/2015
Last updated
01/16/2015
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