Provider Demographics
NPI:1588733695
Name:VASCHE, TERRI L (OD)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:L
Last Name:VASCHE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1404
Mailing Address - Country:US
Mailing Address - Phone:503-873-8619
Mailing Address - Fax:503-873-8282
Practice Address - Street 1:600 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1404
Practice Address - Country:US
Practice Address - Phone:503-873-8619
Practice Address - Fax:503-873-8282
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1454ATI152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT82373Medicare UPIN