NPI 1699532069 · live from the CMS NPI Registry
Mary Joyce Avisado
Optometrist in Forest Grove, OR. National Provider Identifier 1699532069, active.
NPI record
| NPI | 1699532069 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 2043 College Way, Forest Grove, OR 97116 |
| Practice phone | 503-352-2020 |
| Enumerated | March 4, 2024 |
| Last updated | June 17, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist, Corneal and Contact Management | 152WC0802X | ATI4728 (OR) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Optometrist primary | 152W00000X | ATI4728 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.