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General NPI Number Information
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NPI Number | 1134429970
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Entity Type | Individual
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Provider Name | CHRISTOPHER M SPAFFORD O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 01/07/2017
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Provider Practice Location Address
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Address Line | 12300 SE 82ND AVE
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City | PORTLAND
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State | OR
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Zip | 97086-7717
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Country | US
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Telephone | 503-653-5935
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Fax |
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Provider Business Mailing Address
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Address Line | 17413 NE 167TH AVE
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City | BRUSH PRAIRIE
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State | WA
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Zip | 98606-7208
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Country | US
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Telephone | 530-945-0802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3518AT
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD60377067
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License Number State | WA
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