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Active NPI 1083690655 Organization (Entity Type 2)

Keizer Vision Source Pc

Optometrist • Keizer, OR

About Keizer Vision Source Pc NPI 1083690655 Summary

Keizer Vision Source Pc is a verified healthcare organization specializing in Optometrist operating in Keizer, OR. Located at 4350 CHERRY AVE NE, this facility provides patient care and medical services under National Provider Identifier (NPI) 1083690655.

Administrative operations and authorized compliance are overseen by Cynthia Strawn (President).

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

Facility Location & Contact Primary Location

Facility Address

4350 Cherry Ave Ne

Keizer, OR 973034855

Telephone 5033936060
Fax 5033935096

Authorized Official Information

Authorized Contact Name

DR. Cynthia Strawn , OD

Title / Role

President

Official Telephone

5033936060

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

Facility & Registry History Timeline

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

6 Historical Events
✅
NPI Profile Active March 08, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location March 08, 2012

Registered at 4350 CHERRY AVE NE, KEIZER, OR 973034855 (Tel: 5033936060)

📍
Updated Business Mailing Address March 08, 2012

Registered at 4350 CHERRY AVE NE, KEIZER, OR 973034855 (Tel: 5033936060)

🏛️
Organization / Clinic Name Updated March 08, 2012

Operating as KEIZER VISION SOURCE PC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 08, 2012

Optometrist

🟢
Initial NPI Registration & Enumeration December 15, 2005

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1083690655
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: December 15, 2005
Last Update: March 08, 2012
Update or Correct Listing

Mailing Address

4350 Cherry Ave Ne

Keizer, OR 973034855

Phone: 5033936060

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.