Healthcare Provider Details

I. General information

NPI: 1154632917
Provider Name (Legal Business Name): ANNA D CURTTRIGHT O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIE CURTTRIGHT O.D.

II. Dates (important events)

Enumeration Date: 06/27/2010
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2474 SE BURNSIDE RD
GRESHAM OR
97080-1247
US

IV. Provider business mailing address

21866 NE LARKSPUR LN
FAIRVIEW OR
97024-6785
US

V. Phone/Fax

Practice location:
  • Phone: 402-366-8402
  • Fax:
Mailing address:
  • Phone: 402-366-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3354ATI
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: