Healthcare Provider Details

I. General information

NPI: 1659307932
Provider Name (Legal Business Name): ADINA NELA ZAPODEANU O.D., F.A.A.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20407 SW BORCHERS DR SUITE 202
SHERWOOD OR
97140-8760
US

IV. Provider business mailing address

PO BOX 325
SHERWOOD OR
97140-0325
US

V. Phone/Fax

Practice location:
  • Phone: 503-625-2727
  • Fax: 503-625-2929
Mailing address:
  • Phone: 503-625-2727
  • Fax: 503-625-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3152 ATI
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2475
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4096
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: