NPIMap

Organization Active NPI

Eyehealth Northwest Optical, LLC

  • Eyewear Supplier
  • Happy Valley, OR
National Provider Identifier
1124278213
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYEHEALTH NORTHWEST OPTICAL, LLC
Practice address
15963 SE Happy Valley Town Center Dr
Happy Valley, OR 97086-4253
Phone
(503) 344-5102
Fax
(503) 344-5110
NPI assigned
Sep 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Dr. Robert Wells Bentley, MD
Title
President
Phone
(503) 557-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

15963 SE Happy Valley Town Center Dr
Happy Valley, OR 97086-4253

Mailing address

11086 SE Oak St
Milwaukie, OR 97222-6692
Phone (503) 557-2020

National Provider Directory

National Provider Directory
Tax ID family
Eye Health Northwest Optical LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15963 SE Happy Valley Town Center Dr
Happy Valley, OR 97086
Phone (503) 344-5102

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1124278213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11086 SE OAK ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226692",
            "telephone_number": "503-557-2020",
            "fax_number": "503-344-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15963 SE HAPPY VALLEY TOWN CENTER DR",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864253",
            "telephone_number": "503-344-5102",
            "fax_number": "503-344-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEHEALTH NORTHWEST OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WELLS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-557-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.