Knowles, Gary

Knowles, Gary is an individual health care provider with primary practice located at 506 Main St , Dallas OR 97338-1915. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Knowles, Gary can be contacted via phone (503) 623-9233.

Contact Information

Primary practice address
506 Main St Dallas OR 97338-1915
Phone: (503) 623-9233
Fax: (503) 623-9233
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1547T Oregon

Profile Details

NPI number 1154364743
LBN Legal business name Knowles, Gary
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Dec 4th, 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 1154364743 NPPES
Oregon MEDICAID 279018
Oregon Other 0310568863
Oregon Other 022775000
Oregon Other 7072090
Oregon Other 93093
Oregon Other 002118501001
Oregon Other 93082710497338
Oregon Other 31107
Oregon Other 93029
Oregon Other O000790187

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