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NPI Code Detail

MEDICARE: DR. ROBERT DEAN SCHOUTEN SR. O D

MEDICARE: DR. ROBERT DEAN SCHOUTEN SR. O D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WX0102XOccupational Vision Optometrist983 TOR

General Provider Information

NPI Number : 1114045457
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT DEAN SCHOUTEN SR. O D
Provider Business Mailing Address
First Line : 9931 SE EASTMONT DR
Second Line :
City : GRESHAM
State : OR
Zip : 97080-8608
Country : US
Telephone Number : 503-663-2646
Fax Number : 503-663-0423
Provider Business Practice Location Address
First Line : 1839 MOLALLA AVE
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-4071
Country : US
Telephone Number : 503-656-2453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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