Individual
ALISE NICHOLE ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 249-3429
Mailing address
3010 SW 10TH AVE APT 52, PORTLAND, OR 97239-3059
(949) 303-8969
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3671ATI
OR
152W00000X
Optometrist
NOT YET ISSUED
OR
Other
Enumeration date
04/03/2016
Last updated
02/04/2022
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