IndividualActive
Brandyn Wyatt, OD
NPI 1821773722 · Optometrist · Lebanon, OR
Provider details
- NPI number
- 1821773722
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- License
- 4683ATI (OR)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
90 Market St Ste 20
Lebanon, OR 97355-2396
Phone: (541) 451-2020
Fax: (541) 451-1785
Approximate (ZIP-level) locationGet directions
Mailing address
90 Market St Ste 20
Lebanon, OR 97355-2396
Registry dates
- Enumerated
- 2023-06-19
- Last updated
- 2023-06-19
- Certified
- 2023-06-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.