Provider Demographics
NPI:1841395449
Name:RUMPAKIS, JOHN (OD, MBA)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:RUMPAKIS
Suffix:
Gender:M
Credentials:OD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5780
Mailing Address - Country:US
Mailing Address - Phone:503-968-7595
Mailing Address - Fax:
Practice Address - Street 1:5435 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5780
Practice Address - Country:US
Practice Address - Phone:503-968-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist