Healthcare Provider Details

I. General information

NPI: 1194355123
Provider Name (Legal Business Name): IRINA STIGNEI OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 NE 69TH AVE
PORTLAND OR
97213-5301
US

IV. Provider business mailing address

1433 NE 69TH AVE
PORTLAND OR
97213-5301
US

V. Phone/Fax

Practice location:
  • Phone: 971-256-3937
  • Fax: 833-642-0438
Mailing address:
  • Phone: 971-256-3937
  • Fax: 833-642-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: IRINA STIGNEI
Title or Position: OPTOMETRIST, OWNER
Credential: OD
Phone: 971-256-3937