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General NPI Number Information
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NPI Number | 1407112956
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Entity Type | Organization
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Legal Business Name | BEAVERTON EYE HEALTH
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 12345 SW HORIZON BLVD STE 49
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City | BEAVERTON
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State | OR
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Zip | 97005
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Country | US
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Telephone | 503-350-2727
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Fax | 503-625-2727
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Provider Business Mailing Address
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Address Line | 20407 SW BORCHERS DR STE 202
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City | SHERWOOD
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State | OR
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Zip | 97140-8988
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Country | US
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Telephone | 503-625-2727
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Fax | 503-625-2727
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADINA NELA ZAPODEANU
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Credential | OD
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Telephone | 503-625-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 3152ATI
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License Number State | OR
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