Organization
ST LUKES EYE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY ANN BETTS (OFFICE MANAGER)
(503) 698-2300
Entity
Organization
Contact information
Practice address
10365 SE SUNNYSIDE RD, SUITE 150, CLACKAMAS, OR 97015-5741
(503) 698-2300
(503) 698-2308
Mailing address
10365 SE SUNNYSIDE RD, SUITE 150, CLACKAMAS, OR 97015-5741
(503) 698-2300
(503) 698-2308
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35519
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067231
—
OR
01
—
20W00000X
TAXONOMY
OR
Enumeration date
12/03/2007
Last updated
12/03/2007
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