Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1608 ATI | OR |
N | 152W00000X | Optometrist | 1821 | WA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 1608 ATI | OR |
NPI | 1225147408 |
---|---|
Provider Name | Dr. Jared S Nuffer |
First Address | Portland, OR 97233-5757 |
Second Address | Portland, OR 97233-5757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 20/04/2016 |