Provider Demographics
NPI:1093893547
Name:COUPLE OF EYES VISION CARE, P.C.
Entity Type:Organization
Organization Name:COUPLE OF EYES VISION CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-466-2966
Mailing Address - Street 1:2326 NW AMBERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6952
Mailing Address - Country:US
Mailing Address - Phone:503-466-2966
Mailing Address - Fax:503-466-2008
Practice Address - Street 1:2326 NW AMBERBROOK DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6952
Practice Address - Country:US
Practice Address - Phone:503-466-2966
Practice Address - Fax:503-466-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2796ATI152WC0802X
OR2905ATI152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Not Answered152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
131001Medicare PIN