Healthcare Provider Details

I. General information

NPI: 1285271551
Provider Name (Legal Business Name): HOBAN VISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 NE CESAR E CHAVEZ BLVD
PORTLAND OR
97212-5322
US

IV. Provider business mailing address

7016 SW NYBERG ST
TUALATIN OR
97062-9231
US

V. Phone/Fax

Practice location:
  • Phone: 503-288-6181
  • Fax: 503-288-7690
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEELY HOBAN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 503-692-2020