Individual
TAMMIE KRISCIUNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3375 SW TERWILLIGER BLVD, PORTLAND, OR 97239
(503) 494-0837
(503) 418-0049
Mailing address
PO BOX 4183, PORTLAND, OR 97208
(503) 494-6107
(503) 494-0470
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2565ATI
OR
Other
Enumeration date
05/12/2006
Last updated
07/08/2007
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