IndividualActive
Vayakone Philavanh, LDO
NPI 1710094560 · Optician · Portland, OR
Provider details
- NPI number
- 1710094560
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Credential
- LDO
- Sex
- Female
- Sole proprietor
- No
- License
- DO00002172 (WA)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
19500 Se Stark St
Portland, OR 97233-5757
Phone: (503) 669-3995
Fax: (503) 669-3956
Approximate (ZIP-level) locationGet directions
Mailing address
22298 Ne Failing St
Fairview, OR 97024-8758
Registry dates
- Enumerated
- 2006-08-25
- 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.