Provider Demographics
NPI:1639646912
Name:SPECTACLE LLC
Entity Type:Organization
Organization Name:SPECTACLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:LANDON
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-863-0081
Mailing Address - Street 1:2250 NW LOVEJOY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3020
Mailing Address - Country:US
Mailing Address - Phone:503-719-5179
Mailing Address - Fax:971-302-6934
Practice Address - Street 1:2905 SW CEDAR HILLS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1342
Practice Address - Country:US
Practice Address - Phone:503-719-5179
Practice Address - Fax:971-302-6934
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECTACLE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty