Provider Demographics
NPI:1477517704
Name:MAIER, DENISE GRAESSLEY (OD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:GRAESSLEY
Last Name:MAIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:J
Other - Last Name:GRAESSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1550 OAK ST
Mailing Address - Street 2:STE #3
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-683-2020
Mailing Address - Fax:541-683-1509
Practice Address - Street 1:1550 OAK ST
Practice Address - Street 2:STE #3
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-683-2020
Practice Address - Fax:541-683-1509
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT2552152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR271045Medicaid
P00348117OtherRAILROAD MEDICARE
R133977Medicare PIN
OR271045Medicaid
R133976Medicare PIN