NPIMap

Organization Active NPI

Eyehealth Northwest Opti Cal, LLC

  • Eyewear Supplier
  • Portland, OR
National Provider Identifier
1831304674
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYEHEALTH NORTHWEST OPTI CAL, LLC
Practice address
3246 N Lombard St
Portland, OR 97217-1206
Phone
(503) 285-1671
Fax
(503) 285-7859
NPI assigned
May 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

3246 N Lombard St
Portland, OR 97217-1206

Mailing address

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

Other names 1

  • NORTH PORTLAND OPTICAL Other name

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.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831304674",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3246 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171206",
            "telephone_number": "503-285-1671",
            "fax_number": "503-285-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEHEALTH NORTHWEST OPTI CAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "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": [
        {
            "organization_name": "NORTH PORTLAND OPTICAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.