Provider Demographics
NPI:1184323255
Name:PALMER EYE CARE, LLC
Entity type:Organization
Organization Name:PALMER EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-312-6114
Mailing Address - Street 1:17510 PROVOST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-5199
Mailing Address - Country:US
Mailing Address - Phone:971-356-0848
Mailing Address - Fax:971-356-0850
Practice Address - Street 1:17510 PROVOST ST STE 103
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-5199
Practice Address - Country:US
Practice Address - Phone:971-356-0848
Practice Address - Fax:971-356-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty