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General NPI Number Information
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NPI Number | 1639913676
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Entity Type | Organization
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Legal Business Name | ENVISION EYECARE FOR ALL
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Dates
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Enumeration Date | 06/24/2024
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 717 MONTELLO AVE
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City | HOOD RIVER
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State | OR
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Zip | 97031-2156
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Country | US
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Telephone | 503-754-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 717 MONTELLO AVE
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City | HOOD RIVER
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State | OR
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Zip | 97031-2156
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Country | US
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Telephone | 503-754-5625
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Fax |
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Authorized Official
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Title or Position | FOUNDER/PRESIDENT
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Name | REBECCA R CHOWN
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Credential | OD
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Telephone | 503-754-5625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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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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