Individual
DAN CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
125 NW MILLER AVE, GRESHAM, OR 97030-7225
(503) 665-5415
(503) 492-2313
Mailing address
125 NW MILLER AVE, GRESHAM, OR 97030-7225
(503) 665-5415
(503) 492-2313
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1627T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290155
—
OR
Enumeration date
08/19/2005
Last updated
09/22/2010
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