Provider Demographics
NPI:1427124312
Name:OGATA EYECARE, PC
Entity type:Organization
Organization Name:OGATA EYECARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:E
Authorized Official - Last Name:OGATA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-281-1115
Mailing Address - Street 1:1248 LLOYD CTR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1301
Mailing Address - Country:US
Mailing Address - Phone:503-281-1115
Mailing Address - Fax:503-288-2621
Practice Address - Street 1:1248 LLOYD CTR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1301
Practice Address - Country:US
Practice Address - Phone:503-281-1115
Practice Address - Fax:503-288-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1716T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OROOWFBYKAMedicare ID - Type Unspecified
ORT87404Medicare UPIN