Provider Demographics
NPI:1588412068
Name:EASTERN OREGON FAMILY EYECARE
Entity type:Organization
Organization Name:EASTERN OREGON FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:541-203-3159
Mailing Address - Street 1:720 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-1230
Mailing Address - Country:US
Mailing Address - Phone:541-203-3159
Mailing Address - Fax:
Practice Address - Street 1:1100 SOUTHGATE STE 5
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3974
Practice Address - Country:US
Practice Address - Phone:541-969-3445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty