Provider Demographics
NPI:1114373644
Name:VISION CENTER, LLC
Entity Type:Organization
Organization Name:VISION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-923-2020
Mailing Address - Street 1:632 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2752
Mailing Address - Country:US
Mailing Address - Phone:541-923-2020
Mailing Address - Fax:
Practice Address - Street 1:632 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2752
Practice Address - Country:US
Practice Address - Phone:541-923-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2547AT156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty