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1982800470

NPI Code Detail

MEDICARE: PAUL STANLEY TLUCEK MD

MEDICARE: PAUL STANLEY TLUCEK MD

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	207WX0107X	Retina Specialist (Ophthalmology) Physician	MD60335872	WA
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	MD161778	OR
3	207R00000X	Internal Medicine Physician	25649	OK
4	207W00000X	Ophthalmology Physician	60335872	WA
5	207W00000X	Ophthalmology Physician	39381	IA
6	207W00000X	Ophthalmology Physician	161778	OR

General Provider Information

NPI Number	:	1982800470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL STANLEY TLUCEK MD

Provider Business Mailing Address
First Line	:	4225 NE ST JAMES RD
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98663-2148
Country	:	US
Telephone Number	:	503-274-2121
Fax Number	:	866-843-7990

Provider Business Practice Location Address
First Line	:	5440 SW WESTGATE DR STE 217
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97221-2421
Country	:	US
Telephone Number	:	503-274-2121
Fax Number	:	866-843-7990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	10/01/2024

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Directions to “ PAUL STANLEY TLUCEK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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