Slabtown Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SLABTOWN EYE CARE LLC

Doing business as

Slabtown Eye Care

Practice address

1415 NW 21St Ave
Portland, OR 97209-2176

Phone

(503) 894-7200

Fax

(503) 894-7201

NPI assigned

Oct 21, 2024

Last updated

Nov 13, 2024By 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. Johnny Duong, ODNPI 1811370968

Title

Owner

Phone

(503) 894-7200

Specialties & licenses 1

Addresses

Other names 1

• SLABTOWN EYE CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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.

• Johnny Duong, O.D.

  • Optometrist
  • Portland, OR
  • NPI 1811370968
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1649091752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 NW 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092176",
            "telephone_number": "503-894-7200",
            "fax_number": "503-894-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 NW 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092176",
            "telephone_number": "503-894-7200",
            "fax_number": "503-894-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLABTOWN EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "DUONG",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-894-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLABTOWN EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SLABTOWN EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• April Slabosheski
• Emma Slachta, NP
• Jennifer Lynn Slack
• Jennifer M Slack, MD
• Emily Katherine Sladicka
• Kealoha Slagle

• 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 Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.