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General NPI Number Information
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NPI Number | 1295550705
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Entity Type | Organization
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Legal Business Name | DESIGNER EYEWEAR SOLUTIONS LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2355 STATE ST STE 101
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City | SALEM
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State | OR
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Zip | 97301-4541
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Country | US
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Telephone | 503-914-1035
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 653
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City | PORTLAND
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State | OR
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Zip | 97207-0653
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PATRICK MCDONALD
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Credential |
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Telephone | 503-474-8813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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