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General NPI Number Information
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NPI Number | 1689025678
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Entity Type | Organization
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Legal Business Name | KATHERINE A. RUECKER, O.D, & ASSOCIATES, P.C.
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 06/30/2016
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Provider Practice Location Address
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Address Line | 2100 NW ALLIE AVE
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City | HILLSBORO
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State | OR
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Zip | 97124-9079
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Country | US
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Telephone | 503-531-3540
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Fax | 503-439-9971
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Provider Business Mailing Address
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Address Line | 2100 NW ALLIE AVE
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City | HILLSBORO
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State | OR
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Zip | 97124-9079
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Country | US
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Telephone | 503-531-3540
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Fax | 503-439-9971
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHERINE ANNE RUECKER
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Credential | O.D.
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Telephone | 503-531-3540
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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 | 2837ATI
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License Number State | OR
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