Individual
DR. LEVI RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2804 19TH AVE, FOREST GROVE, OR 97116-2625
(503) 357-2020
(503) 357-6995
Mailing address
2804 19TH AVE, FOREST GROVE, OR 97116-2625
(503) 357-2020
(503) 357-6995
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4634
OR
Other
Enumeration date
06/11/2022
Last updated
06/11/2022
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