Provider Demographics
NPI:1164587754
Name:GARHOFER, NEAL JAMES (OD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:JAMES
Last Name:GARHOFER
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 1:695 S HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-9319
Mailing Address - Country:US
Mailing Address - Phone:150-371-7247
Mailing Address - Fax:503-861-9830
Practice Address - Street 1:695 S HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-9319
Practice Address - Country:US
Practice Address - Phone:503-861-9829
Practice Address - Fax:503-861-9830
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2199T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU30034Medicare UPIN
ORR0000PHGWNMedicare PIN