NPI 1639433774 · live from the CMS NPI Registry
Jamy Van Wyck Borbidge, O.D.
Optometrist in Forest Grove, OR. National Provider Identifier 1639433774, active.
NPI record
| NPI | 1639433774 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 2043 College Way, Forest Grove, OR 97116 |
| Practice phone | 503-352-2020 |
| Mailing address | 11 Windsor Rd, Bow, NH 03304 |
| Enumerated | July 3, 2012 |
| Last updated | May 11, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 4993 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.