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General NPI Number Information
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NPI Number | 1033262563
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Entity Type | Organization
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Legal Business Name | BLINK LLC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 2719 SE 21ST AVENUE
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City | PORTLAND
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State | OR
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Zip | 97202-2236
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Country | US
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Telephone | 503-546-2565
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Fax | 503-546-2680
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Provider Business Mailing Address
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Address Line | 2719 SE 21ST AVENUE
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City | PORTLAND
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State | OR
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Zip | 97202-2236
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Country | US
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Telephone | 503-546-2565
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Fax | 503-546-2680
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW ARMSTRONG
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Credential | O.D.
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Telephone | 503-546-2565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2986ATI
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License Number State | OR
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