Organization
EYE HEALTH NORTHWEST OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WELLS BENTLEY MD (PRESIDENT)
(503) 557-2020
Entity
Organization
Contact information
Practice address
15405 SW 116TH AVE, SUITE 204, PORTLAND, OR 97224-4101
(503) 620-4070
(503) 598-9661
Mailing address
PO BOX 22009, MILWAUKIE, OR 97269-2009
(503) 557-2020
(503) 344-5110
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
11/18/2005
Last updated
09/17/2008
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