Edward Nicholas Mulder, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1245ATI Issued in OR

Practice address

12100 SE Stevens CT
Ste. 106
Portland, OR 97086-4707

Phone

(503) 353-7300

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1669567780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 SE STEVENS CT",
            "address_2": "STE. 106",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970864707",
            "telephone_number": "503-353-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 SE STEVENS CT",
            "address_2": "STE. 106",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970864707",
            "telephone_number": "503-353-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "EDWARD",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1245ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ashley Mulcahy- Nicholson
• Peggy Ann Mulcahy, M.D.
• Amy L Mulcaster, DO
• Donald L Mulconrey, PA-C
• Melissa Kay Mulder-Wright, MSW-LCSW
• Shala Muldrew
• Camilla Muldrow, CPPD, CD
• Eduardo Mulero, DDS
• Amelia Jane Mulford, CGC
• Shanice Nicole Muliro

• 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 Jul 16, 2007; 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.