Provider Demographics
NPI:1760642748
Name:OC EYECARE LLC
Entity Type:Organization
Organization Name:OC EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIIST
Authorized Official - Prefix:
Authorized Official - First Name:SKY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-272-1854
Mailing Address - Street 1:405 NE 10TH CT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-2815
Mailing Address - Country:US
Mailing Address - Phone:541-272-1854
Mailing Address - Fax:
Practice Address - Street 1:150 NE 20TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-1851
Practice Address - Country:US
Practice Address - Phone:541-265-4201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2839AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty