Provider Demographics
NPI:1699937813
Name:OULMAN, BRIAN CHARLES (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHARLES
Last Name:OULMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4403
Mailing Address - Country:US
Mailing Address - Phone:509-290-8189
Mailing Address - Fax:
Practice Address - Street 1:1000 SW INDIAN AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-3039
Practice Address - Country:US
Practice Address - Phone:541-548-2488
Practice Address - Fax:541-548-5334
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60022675152W00000X
CA14753TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist