IndividualActive
Jonathan Gregory
NPI 1073609871 · Optician · Beaverton, OR
Provider details
- NPI number
- 1073609871
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
4855 Sw Western Ave
Beaverton, OR 97005-3460
Phone: (503) 643-7565
Approximate (ZIP-level) locationGet directions
Mailing address
3755 Ne Sumner St
Portland, OR 97211
Registry dates
- Enumerated
- 2006-10-05
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.