Individual
MILA IOUSSIFOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD, CNS, FAAO
Contact information
Practice address
3615 SW RIVER PKWY, PORTLAND, OR 97239-4552
(971) 229-0820
(971) 229-0821
Mailing address
3615 SW RIVER PKWY, PORTLAND, OR 97239-4552
(971) 229-0820
(971) 229-0821
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3296AT
OR
152W00000X
Optometrist
Primary
ATI3296
OR
Other
Enumeration date
09/05/2007
Last updated
10/22/2024
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