Provider Demographics
NPI:1689025678
Name:KATHERINE A. RUECKER, O.D, & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:KATHERINE A. RUECKER, O.D, & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RUECKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-531-3540
Mailing Address - Street 1:2100 NW ALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9079
Mailing Address - Country:US
Mailing Address - Phone:503-531-3540
Mailing Address - Fax:503-439-9971
Practice Address - Street 1:2100 NW ALLIE AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9079
Practice Address - Country:US
Practice Address - Phone:503-531-3540
Practice Address - Fax:503-439-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2837ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty