Provider Demographics
NPI:1013045152
Name:SHERWOOD FAMILY EYE HEALTH LLC
Entity Type:Organization
Organization Name:SHERWOOD FAMILY EYE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ZAPODEANU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-625-2727
Mailing Address - Street 1:20407 SW BORCHERS DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8760
Mailing Address - Country:US
Mailing Address - Phone:503-625-2727
Mailing Address - Fax:503-625-2929
Practice Address - Street 1:20407 SW BORCHERS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8760
Practice Address - Country:US
Practice Address - Phone:503-625-2727
Practice Address - Fax:503-625-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3152 ATI261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR241823Medicaid
OR5844990001Medicare NSC