Healthcare Provider Details

I. General information

NPI: 1306954011
Provider Name (Legal Business Name): PACIFIC UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SE 8TH AVE STE 114
HILLSBORO OR
97123-4218
US

IV. Provider business mailing address

2043 COLLEGE WAY # A134
FOREST GROVE OR
97116-1756
US

V. Phone/Fax

Practice location:
  • Phone: 503-352-7300
  • Fax: 971-266-2961
Mailing address:
  • Phone: 503-352-7300
  • Fax: 971-266-2961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number163863
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISA DOWNING
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 503-352-2663