Provider Demographics
NPI:1558540641
Name:CATHERINE SAUL, OD, LLC
Entity Type:Organization
Organization Name:CATHERINE SAUL, OD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-668-8112
Mailing Address - Street 1:37685 SE OLSON ST
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-9539
Mailing Address - Country:US
Mailing Address - Phone:503-668-8112
Mailing Address - Fax:
Practice Address - Street 1:36745 HIGHWAY 26
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-7211
Practice Address - Country:US
Practice Address - Phone:503-668-7931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2474ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
140471Medicare PIN