Healthcare Provider Details

I. General information

NPI: 1437053790
Provider Name (Legal Business Name): EMILY LEAH BOYCO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 E BARNETT RD
MEDFORD OR
97504-8219
US

IV. Provider business mailing address

1254 ALDERSIDE ROAD
PORT MOODY BC
V3H 3A7
CA

V. Phone/Fax

Practice location:
  • Phone: 541-779-4711
  • Fax: 541-779-0796
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberATI4854
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: