Provider Demographics
NPI:1043208937
Name:SILVER FALLS EYECARE, P.C.
Entity Type:Organization
Organization Name:SILVER FALLS EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:VASCHE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-873-8619
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1454T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR105725Medicare PIN