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General NPI Number Information
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NPI Number | 1679600977
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Entity Type | Organization
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Legal Business Name | DR. PAUL M. WEHNER & ASSOCIATES, PC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15320 NW CENTRAL DR D8
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City | PORTLAND
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State | OR
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Zip | 97229-0988
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Country | US
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Telephone | 503-645-1116
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Fax | 503-645-0776
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Provider Business Mailing Address
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Address Line | 15320 NW CENTRAL DR D8
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City | PORTLAND
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State | OR
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Zip | 97229-0988
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Country | US
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Telephone | 503-645-1116
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Fax | 503-645-0776
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL M. WEHNER
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Credential | O.D.
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Telephone | 503-645-1116
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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 | 2742ATI
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License Number State | OR
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