Hill, Stacy Jo
Hill, Stacy Jo is an individual health care provider with primary practice located at 4655 Sw Griffith Dr Ste 165 , Beaverton OR 97005-8731. She recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Hill, Stacy Jo can be contacted via phone (503) 646-8592.Contact Information
Primary practice address
4655 Sw Griffith Dr Ste 165
Beaverton OR 97005-8731
Phone: (503) 646-8592
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 3548ATI | Oregon |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 3548ATI | Oregon |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3548ATI | Oregon |
Profile Details
| NPI number | 1457765604 |
|---|---|
| LBN Legal business name | Hill, Stacy Jo |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2014 |
| Last updated | Dec 6th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457765604 | NPPES |
| Oregon | MEDICAID | 500673809 |
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