MEDICARE: MURRAY SCHOLLS OPTIQUE INC

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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1598751802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURRAY SCHOLLS OPTIQUE INC

Provider Business Mailing Address
First Line	:	14600 SW MURRAY SCHOLLS DR
Second Line	:	SUITE 104
City	:	BEAVERTON
State	:	OR
Zip	:	97007-9712
Country	:	US
Telephone Number	:	503-579-6695
Fax Number	:	503-579-6658

Provider Business Practice Location Address
First Line	:	14600 SW MURRAY SCHOLLS DR
Second Line	:	SUITE 104
City	:	BEAVERTON
State	:	OR
Zip	:	97007-9712
Country	:	US
Telephone Number	:	503-579-6695
Fax Number	:	503-579-6658

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TODD SHELDON
Credential	:	OD
Telephone Number	:	503-579-6695

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	04/16/2024

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