URBAN EYE GALLERY, LLC (NPI# 1124466545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124466545 |
| Entity Type | Organization |
| Organization Name | URBAN EYE GALLERY, LLC |
| Other Organization Name | EYE DEPARTMENT |
| Practice Address |
921 Sw 16th Ave Portland OR 97205-1730 |
| Practice Telephone | 5032270573 |
| Mailing Telephone | 5032270573 |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |
| Authorized Official Name | ANITA PHROMSIVARAK BACON (MANAGING MEMBER) |
| Authorized Official Telephone | 5032270573 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3195 ATI | OR | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Eye Department | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | URBAN EYE GALLERY, LLC | 921 Sw 16th Ave, Portland, OR 97205 |
| Street Address |
921 SW 16TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97205-1730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366583684 | Anita (annie) Phromsivarak Bacon | Optometrist | 921 Sw 16th Ave, Portland, OR 97205-1730 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1114374949 | Elizabeth Alire | Counselor | 1411 Sw Morrison St., Portland, OR 97205 | 2016-05-23 |
| 1508237462 | Pacific Psychology and Comprehensive Health Center | Community/Behavioral Health | 1411 Sw Morrison Ave, Suite 310, Portland, OR 97205 | 2015-10-16 |
| 1265803761 | Alana Branson | Naturopath | 1033 Sw Yamhill Street, Suite 403, Portland, OR 97205 | 2015-10-10 |
| 1720458011 | Kate Ohene | Counselor | 1411 Sw Morrison Street, Suite 310, Portland, OR 97205 | 2015-09-30 |
| 1285004671 | Christina Nannette Mendoza | Counselor | 1411 Sw Morriston Street, 310, Portland, OR 97205 | 2015-09-29 |
| 1083095947 | Patricia Burton | Registered Nurse | 1312 Sw Washinghton, Portland, OR 97205 | 2015-06-16 |
| 1649663071 | Huey Holistic | Clinic/Center | 1221 Sw Yamill, Suite 300, Portland, OR 97205 | 2015-03-10 |
| 1376952796 | Joan Kendall Ayala | Counselor | 610 Sw Alder St Ste 915, Portland, OR 97205 | 2014-08-11 |
| 1316356165 | Satheara Sin | Massage Therapist | 1033 Sw Yamhill St. #403, Portland, OR 97205 | 2014-08-06 |
| Find all providers in zip 97205 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376162008 | Eyestrong, LLC | Optometrist | 3934 Ne Mlk Jr Blvd Ste 101, Portland, OR 97212-1153 | 2020-04-13 |
| 1740816768 | Allison Kuo | Optometrist | 3710 Sw Us Veterans Hospital Rd Bldg 1008c140, Portland, OR 97239-2964 | 2020-03-21 |
| 1689235160 | Maja Krsmanovic | Optometrist | 14 Buca Run, Portland, ME 04103-1427 | 2019-06-25 |
| 1407416225 | Sarah Fowler | Optometrist | 605 S Broadway St, Portland, TN 37148-1619 | 2019-06-14 |
| 1720645302 | Ryan Steve Kucala | Optometrist | 520 Nw Lost Springs Ter # Unite203, Portland, OR 97229-6655 | 2019-05-20 |
| 1023575925 | Pacific Eye Group, PC | Optometrist | 1006 Lloyd Ctr, Portland, OR 97232-1266 | 2019-02-27 |
| 1811472749 | Carole Tong | Optometrist | 8136 Se Foster Rd Ste 260, Portland, OR 97206-4288 | 2018-09-26 |
| 1528580354 | Dr. Han Tran & Associates, P.C. | Optometrist | 12100 Se 82nd Ave, Portland, OR 97086-7755 | 2017-07-13 |
| 1306384128 | Daniel & Max, LLC | Optometrist | 8795 Sw Scholls Ferry Rd, Portland, OR 97223-4409 | 2017-02-01 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.