OrganizationActive
Eyedentity Vision Center P.C.
NPI 1003930132 · Optometrist · Portland, OR
Eyedentity Vision Center P.C. is a Optometrist organization in Portland, OR (NPI 1003930132).
Provider details
- NPI number
- 1003930132
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Steven Clouse, President(503) 238-1139
- License
- 2408T (OR)
Practice location
2609 Se Clinton St
Portland, OR 97202-1240
Phone: (503) 238-1139
Fax: (503) 235-6574
Street-level locationGet directions
Mailing address
2609 Se Clinton St
Portland, OR 97202-1240
Registry dates
- Enumerated
- 2007-03-16
- Last updated
- 2009-10-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.