- Practice location
- 1962 SW Broadway, Portland, OR 97201-6710
- Phone
- 503-223-6655
- Fax
- 503-233-6657
- Last updated
- November 13, 2007
Broadway Vision World is a healthcare organization based in Portland, OR. The NPI number for Broadway Vision World is 1295915700 and holds license No. 1863T (OR). The current practice location address is 1962 SW Broadway, Portland, OR 97201-6710 and the office can be reached by phone at 503-223-6655 and by fax at 503-233-6657. The NPI was assigned on November 13, 2007 and the record was last updated in NPPES on November 13, 2007.
●Provider Profile Details
- NPI Number
- 1295915700
- Provider Name
- Broadway Vision World
- Entity Type
- Organization (Type 2 NPI)
- Primary Taxonomy
- Optometrist · 152W00000X
- Organization Subpart
- No
- Authorized Official
- Dr. Kamelia Massih, OD · Ceo · 503-223-6655
- Enumeration Date
- November 13, 2007
- Last Update Date
- November 13, 2007
- NPI Status
- Active
◉Business Practice Location Address
- Address
- 1962 SW Broadway
Portland, OR 97201-6710 - City
- Portland
- State
- Oregon
- ZIP
- 97201-6710
- Country
- US
- Phone Number
- 503-223-6655
- Fax Number
- 503-233-6657
✉Business Mailing Address
- Address
- Po Box 108
Beaverton, OR 97075-0108 - City
- Beaverton
- State
- OR
- ZIP
- 97075-0108
- Phone Number
- 503-223-6655
- Fax Number
- 503-223-6657
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Optometrist 193400000X - Single Specialty Group | 152W00000X | Yes | 1863T | OR |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
☉Other providers near Portland, OR
View all providers in Portland →?Frequently Asked Questions
What is the NPI number of Broadway Vision World?
The NPI number of Broadway Vision World is 1295915700. It was assigned on November 13, 2007 and is currently active in the NPPES registry.
What is the specialty of Broadway Vision World?
Broadway Vision World is registered under the primary taxonomy Optometrist (code 152W00000X) and holds license No. 1863T (OR).
Where does Broadway Vision World practice?
The practice location is 1962 SW Broadway, Portland, OR 97201-6710. The office can be reached at 503-223-6655 (phone) or 503-233-6657 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1295915700 directly on the NPPES registry website at npiregistry.cms.hhs.gov.