Dr. Larry E Robertson
Optometrist
12100 Se Stevens Ct Ste 106
Portland
, Oregon 97266-8707
Dr. Larry E Robertson
Optometrist
12100 Se Stevens Ct Ste 106
Portland
, Oregon 97266-8707
(503) 655-1611
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Larry E Robertson
- 20279 Danny Ct
- Oregon City, OR
- Zip : 97045-8618
- Phone : (503) 655-1611
Second Address
- Dr. Larry E Robertson
- 12100 Se Stevens Ct Ste 106
- Portland, OR
- Zip : 97266-8707
- Phone : (503) 653-1442
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 152W00000X | Optometrist | 1179 | WA |
| Y | 152W00000X | Optometrist | 1362ATI | OR |
National Provider Identifier
| NPI | 1013022664 |
|---|---|
| Provider Name | Dr. Larry E Robertson |
| First Address | Oregon City, OR 97045-8618 |
| Second Address | Portland, OR 97266-8707 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.