Provider Demographics
NPI:1417269051
Name:DR JOSEPH NERON & ASSOCIATES, INC
Entity Type:Organization
Organization Name:DR JOSEPH NERON & ASSOCIATES, INC
Other - Org Name:MASTER EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:NERON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-643-4840
Mailing Address - Street 1:3205 SW CEDAR HILLS BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1374
Mailing Address - Country:US
Mailing Address - Phone:503-643-4840
Mailing Address - Fax:503-520-9262
Practice Address - Street 1:3205 SW CEDAR HILLS BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1374
Practice Address - Country:US
Practice Address - Phone:503-643-4840
Practice Address - Fax:503-520-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3169ATI261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3169ATIOtherOREGON OPTOMETRY LICENSE NUMBER