Patrick Raymond Buczkowski, OPTICIAN
Individual provider Active NPI Optician · Happy Valley, OR
NPI 1043326085 · NPPES record last updated Feb 5, 2008
Key facts
- NPI
- 1043326085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- Practice address
- 12100 SE Stevens CT
Suite 106
Happy Valley, OR 97086-4707 - Phone
- (503) 353-7300
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Yes |
Addresses
Primary practice location
12100 SE Stevens CT
Suite 106
Happy Valley, OR 97086-4707
Mailing address
12100 SE Stevens CT
Suite 106
Happy Valley, OR 97086-4707
Phone (503) 353-7300
Other providers in Happy Valley, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.