Provider Demographics
NPI:1013277391
Name:ARMSTRONG, LAURA MAE (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MAE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 NE ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-5847
Mailing Address - Country:US
Mailing Address - Phone:503-384-2489
Mailing Address - Fax:503-379-9488
Practice Address - Street 1:2021 NE ALBERTA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-5847
Practice Address - Country:US
Practice Address - Phone:503-384-2489
Practice Address - Fax:503-379-9488
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3473ATI152W00000X, 152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics