MEDICARE: DR. CAROL Z RYMER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	99165899 OPT 1658	CO
2	152W00000X	Optometrist	2472AT	OR

General Provider Information

NPI Number	:	1407847445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL Z RYMER O.D.

Provider Business Mailing Address
First Line	:	135 MORRIS RD
Second Line	:
City	:	WAHIAWA
State	:	HI
Zip	:	96786-5821
Country	:	US
Telephone Number	:	808-433-8461
Fax Number	:	808-433-8471

Provider Business Practice Location Address
First Line	:	2043 COLLEGE WAY
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-1756
Country	:	US
Telephone Number	:	503-352-2020
Fax Number	:	503-352-2261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/15/2019

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