NPI 1376707984 · live from the CMS NPI Registry
Anna R Anderson, O.D.
Optometrist in Portland, OR. National Provider Identifier 1376707984, active.
NPI record
| NPI | 1376707984 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 200 Sw Market St, #L120, Portland, OR 97201 |
| Practice phone | 503-223-8147 |
| Mailing address | 1 Jefferson Pkwy, Apt #328, Lake Oswego, OR 97035 |
| Enumerated | July 12, 2008 |
| Last updated | September 4, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | 13504 (CA) |
| Optometrist | 152W00000X | 1697 (AZ) |
| Optometrist primary | 152W00000X | 3284AT (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.