NPI 1316007669 · live from the CMS NPI Registry
Mauri Donn Bauer, O.D.
Optometrist in Portland, OR. National Provider Identifier 1316007669, active.
NPI record
| NPI | 1316007669 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 5901 Sw Macadam Ave, Ste 105, Portland, OR 97239 |
| Practice phone | 503-222-2990 |
| Enumerated | December 9, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 1470-ATI (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.