Provider Demographics
NPI:1801021084
Name:ROWLAND, CHRISTOPHER KEITH (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KEITH
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 32ND PL
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-2678
Mailing Address - Country:US
Mailing Address - Phone:503-453-2940
Mailing Address - Fax:
Practice Address - Street 1:1146 32ND PL
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2678
Practice Address - Country:US
Practice Address - Phone:503-453-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3368ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist