Individual
DR. ROBERT BRUCE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1505 NW HARRISON BLVD, CORVALLIS, OR 97330-5816
(541) 754-6222
(541) 757-2055
Mailing address
1505 NW HARRISON BLVD, CORVALLIS, OR 97330-5816
(541) 754-6222
(541) 757-2055
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3026ATI
OR
152WC0802X
Corneal and Contact Management Optometrist
3026ATI
OR
152WP0200X
Pediatric Optometrist
3026ATI
OR
152WS0006X
Sports Vision Optometrist
3026ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055502002
BLUE CROSS
OR
01
—
3026ATI
PIN #
OR
Enumeration date
02/23/2006
Last updated
12/30/2009
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