NPI 1376461657 · live from the CMS NPI Registry
Dane Agost
Optometrist in Gresham, OR. National Provider Identifier 1376461657, active.
NPI record
| NPI | 1376461657 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 125 Nw Miller Ave, Gresham, OR 97030 |
| Practice phone | 503-665-3813 |
| Mailing address | 12976 Se 126th Ave, Happy Valley, OR 97086 |
| Enumerated | July 6, 2026 |
| Last updated | July 6, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 4829 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.