Provider Demographics
NPI:1134180524
Name:FROLAND, LAWRENCE ALFRED (OD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALFRED
Last Name:FROLAND
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 1:2306 SE WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7634
Mailing Address - Country:US
Mailing Address - Phone:503-654-3212
Mailing Address - Fax:503-652-2460
Practice Address - Street 1:2306 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7634
Practice Address - Country:US
Practice Address - Phone:503-654-3212
Practice Address - Fax:503-652-2460
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR1228AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR063933Medicaid
OR063933Medicaid