Organization
HIGH DESERT EYECARE
Active
Other names
High Desert Vision Source
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHIA DAWN HOLLAND CPOA, CPOC, VSR (CREDENTIALING SPECIALIST)
(541) 923-2221
Entity
Organization
Contact information
Practice address
443 SW EVERGREEN AVE, REDMOND, OR 97756-2817
(541) 923-2221
(541) 923-3776
Mailing address
PO BOX 918, REDMOND, OR 97756-0206
(541) 923-2221
(541) 923-3776
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2601AT
OR
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213242
—
OR
05
—
236083
—
OR
05
—
244121
—
OR
05
—
297153
—
OR
Enumeration date
11/01/2006
Last updated
07/22/2024
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