Organization
FAMILY VISION OF OREGON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL LEROY MANNEN O.D. (PRESIDENT)
(503) 397-2020
Entity
Organization
Contact information
Practice address
1864 COLUMBIA BLVD, SAINT HELENS, OR 97051-1733
(503) 397-2020
(503) 397-7701
Mailing address
1864 COLUMBIA BLVD, SAINT HELENS, OR 97051-1733
(503) 397-2020
(503) 397-7701
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OR 1494 ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127704
—
OR
Enumeration date
05/09/2007
Last updated
06/15/2010
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