Healthcare Provider Details

I. General information

NPI: 1639033715
Provider Name (Legal Business Name): NERON FAROFF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 E HISTORIC COLUMBIA RIVER HWY
TROUTDALE OR
97060
US

IV. Provider business mailing address

266 E HISTORIC COLUMBIA RIVER HWY
TROUTDALE OR
97060
US

V. Phone/Fax

Practice location:
  • Phone: 503-492-3897
  • Fax:
Mailing address:
  • Phone: 503-492-3897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSEPH DONALD NERON
Title or Position: OWNER
Credential: OD
Phone: 971-570-1843