NPIMap

Organization Active NPI

Eye Health Northwest Optical, LLC

  • Eyewear Supplier
  • Portland, OR
National Provider Identifier
1992787410
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYE HEALTH NORTHWEST OPTICAL, LLC
Practice address
15405 SW 116TH Ave
Suite 204
Portland, OR 97224-4101
Phone
(503) 620-4070
Fax
(503) 598-9661
NPI assigned
Nov 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 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

15405 SW 116TH Ave
Suite 204
Portland, OR 97224-4101

Mailing address

PO Box 22009
Milwaukie, OR 97269-2009
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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1992787410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22009",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692009",
            "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": "15405 SW 116TH AVE",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972244101",
            "telephone_number": "503-620-4070",
            "fax_number": "503-598-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH NORTHWEST OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-09-17",
        "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 Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.