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Individual

WAYNE L GERIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
10225 SW HALL BLVD, SUITE101, TIGARD, OR 97223-8855
(503) 244-1004
(503) 244-1006
Mailing address
10225 SW HALL BLVD, SUITE 101, TIGARD, OR 97223-8855
(503) 244-1004
(503) 244-1006

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1478AT
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
283135
OR
Enumeration date
03/21/2006
Last updated
11/07/2008
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