Eyedentity Vision Center P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2408T Issued in OR

Legal business name

EYEDENTITY VISION CENTER P.C.

Doing business as

Steven J. Clouse, OD

Practice address

2609 SE Clinton St
Portland, OR 97202-1240

Phone

(503) 238-1139

Fax

(503) 235-6574

NPI assigned

Mar 16, 2007

Last updated

Oct 16, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Steven J Clouse, ODNPI 1285640714

Title

President

Phone

(503) 238-1139

Specialties & licenses 1

Addresses

Other names 1

• Steven J. Clouse, OD Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven J Clouse, O.D.

  • Optometrist
  • Portland, OR
  • NPI 1285640714
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1003930132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 SE CLINTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021240",
            "telephone_number": "503-238-1139",
            "fax_number": "503-235-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 SE CLINTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021240",
            "telephone_number": "503-238-1139",
            "fax_number": "503-235-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEDENTITY VISION CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "CLOUSE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-238-1139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2408T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Steven J. Clouse, OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eye Health Northwest P.C.
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• Eyehealth Northwest Opti Cal, LLC
• Eyehealth Northwest Optical, LLC
• Eyemasters Inc (Binyon's Eye World)
• Eyemasters Inc (Visionworks)
• Eyes on You, PC

• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.