NPI 1972102796 · live from the CMS NPI Registry
Jonathan T Bloemers, OD
Optometrist in Troutdale, OR. National Provider Identifier 1972102796, active.
NPI record
| NPI | 1972102796 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 226 E Historic Columbia River Hwy, Troutdale, OR 97060 |
| Practice phone | 503-492-3897 |
| Enumerated | October 22, 2020 |
| Last updated | March 25, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | ATI4548 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.