Provider Demographics
NPI:1518166933
Name:GRIFFITH, DAWNE RIME (OD)
Entity Type:Individual
Prefix:DR
First Name:DAWNE
Middle Name:RIME
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 SW HAZEL FERN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:503-616-2993
Mailing Address - Fax:503-684-2865
Practice Address - Street 1:7110 SW HAZEL FERN RD.
Practice Address - Street 2:SUITE 200
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224
Practice Address - Country:US
Practice Address - Phone:503-616-2993
Practice Address - Fax:503-684-2865
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2520-ATI152W00000X
OROR2520-ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OROR2520-ATIOtherOREGAN BOARD OF OPTOMETRY