Individual
OLESYA VIESTENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7485 SW BRIDGEPORT RD, TIGARD, OR 97224-7207
(503) 495-5821
Mailing address
7485 SW BRIDGEPORT RD, TIGARD, OR 97224-7207
(503) 495-5821
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3521ATI
OR
Other
Enumeration date
10/06/2010
Last updated
05/13/2022
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