Knowles, Garrett Wayne
Knowles, Garrett Wayne is an individual health care provider with primary practice located at 506 Main St , Dallas OR 97338. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Knowles, Garrett Wayne can be contacted via phone (503) 623-9233.Contact Information
Primary practice address
506 Main St
Dallas OR 97338
Phone: (503) 623-9233
Fax: (503) 837-1047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3399ATI | Oregon |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3399AT | Oregon |
Profile Details
| NPI number | 1790073856 |
|---|---|
| LBN Legal business name | Knowles, Garrett Wayne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2011 |
| Last updated | Dec 12th, 2023 - about last year |
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 | 1790073856 | NPPES |
| Oregon | MEDICAID | 500641229 |
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