NPI 1124107974 · live from the CMS NPI Registry
Bill Louis Borok, OD
Optometrist in Portland, OR. National Provider Identifier 1124107974, active.
NPI record
| NPI | 1124107974 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 3600 N Interstate Ave, Portland, OR 97227 |
| Practice phone | 503-331-5249 |
| Mailing address | 4199 Nw 178th Pl, Portland, OR 97229 |
| Enumerated | November 3, 2006 |
| Last updated | February 10, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 1975ATI (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.