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Active NPI 1619022076 Organization (Entity Type 2) Subpart Facility

Gresham Vision Center, Inc

Optometrist • Gresham, OR

Parent Organization: R104410

About Gresham Vision Center, Inc NPI 1619022076 Summary

Gresham Vision Center, Inc is a verified healthcare organization specializing in Optometrist operating in Gresham, OR. Located at 125 NW MILLER AVE, this facility provides patient care and medical services under National Provider Identifier (NPI) 1619022076.

Gresham Vision Center, Inc operates as a subpart facility of R104410. Administrative operations and authorized compliance are overseen by Diane Gardner (Office Manager).

The facility is associated with 3 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

125 Nw Miller Ave

Gresham, OR 970307225

Telephone 5036653813

Authorized Official Information

Authorized Contact Name

Diane Gardner

Title / Role

Office Manager

Official Telephone

5036653813

Facility Classifications & Specialties

Optometrist Primary Taxonomy

NUCC Taxonomy Code: 152W00000X

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.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

3 Linked
Dane Agost NPI 1376461657

Optometrist

Gresham, OR

View Practitioner Profile →

Optometrist

Gresham, OR

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active March 19, 2015

NPI status registered as active in NPPES database

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Updated Practice Location March 19, 2015

Registered at 125 NW MILLER AVE, GRESHAM, OR 970307225 (Tel: 5036653813)

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Updated Business Mailing Address March 19, 2015

Registered at 125 NW MILLER AVE, GRESHAM, OR 970307225

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Organization / Clinic Name Updated March 19, 2015

Operating as GRESHAM VISION CENTER, INC

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 19, 2015

Optometrist

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Initial NPI Registration & Enumeration January 24, 2007

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1619022076
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: January 24, 2007
Last Update: March 19, 2015

Mailing Address

125 Nw Miller Ave

Gresham, OR 970307225

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.