Buchanan, Derek James

Buchanan, Derek James is an sole proprietor health care provider with primary practice located at 925 Sw Taylor St , Portland OR 97205-2503. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Buchanan, Derek James can be contacted via phone (503) 228-2154.

Contact Information

Primary practice address
925 Sw Taylor St Portland OR 97205-2503
Phone: (503) 228-2154
Fax: (503) 228-4694
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X NOT APPLICABLE Oregon
Eye and Vision Services Providers / Optician 156FX1800X NOT APPLICABLE Oregon

Profile Details

NPI number 1710048335
LBN Legal business name Buchanan, Derek James
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Jun 9th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710048335 NPPES
Oregon Other 838474000 REGENCE BCBS PROVIDER #
Oregon Other TIN CONFIDENTIAL REGENCE BCBS PROVIDER #
Oregon MEDICAID 049424 REGENCE BCBS PROVIDER #
Oregon Other 1931129593 REGENCE BCBS PROVIDER #
Oregon Other TIN CONFIDENTIAL REGENCE BCBS PROVIDER #
Oregon MEDICAID 278184 REGENCE BCBS PROVIDER #
Oregon Other J6344 REGENCE BCBS PROVIDER #
Oregon Other OP1880 REGENCE BCBS PROVIDER #
Oregon Other TIN CONFIDENTIAL REGENCE BCBS PROVIDER #
Oregon Other TIN CONFIDENTIAL REGENCE BCBS PROVIDER #
Oregon Other TIN CONFIDENTIAL REGENCE BCBS PROVIDER #

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