Organization
COASTAL EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA FLORENCE THORSEN (MEMBER)
(360) 484-3417
Entity
Organization
Contact information
Practice address
577 18TH ST, ASTORIA, OR 97103-3505
(503) 325-4401
(503) 325-4449
Mailing address
577 18TH ST, ASTORIA, OR 97103-3505
(503) 325-4401
(503) 325-4449
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2483AT
OR
Other
Enumeration date
07/29/2011
Last updated
10/14/2011
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