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General NPI Number Information
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NPI Number | 1588748248
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Entity Type | Organization
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Legal Business Name | OREGON HEALTH SCIENCES UNIVERSITY DEPARTMENT OF OPHTHALMOLOGY
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 545 SW CAMPUS DR. SUITE 2531
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City | PORTLAND
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State | OR
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Zip | 97239-3130
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Country | US
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Telephone | 503-494-3000
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Fax | 503-494-0470
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Provider Business Mailing Address
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Address Line | 1400 SW 5TH AVE
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City | PORTLAND
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State | OR
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Zip | 97201-5537
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Country | US
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Telephone | 866-617-6855
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Fax | 503-346-8015
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Authorized Official
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Title or Position | VP/ENTERPRISE REVENUE CYCLE
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Name | KELLY ANNE SMITH
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Credential |
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Telephone | 503-494-4422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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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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