Provider Demographics
NPI:1457323495
Name:SAUL, CATHERINE B (OD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:B
Last Name:SAUL
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 1:37685 SE OLSON ST
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-9539
Mailing Address - Country:US
Mailing Address - Phone:503-780-9123
Mailing Address - Fax:503-492-3236
Practice Address - Street 1:2150 NE DIVISION ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5813
Practice Address - Country:US
Practice Address - Phone:503-667-2424
Practice Address - Fax:503-492-3236
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2474ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU49295Medicaid
R117579Medicare ID - Type Unspecified
U49295Medicare UPIN