Provider Demographics
NPI:1811438286
Name:ATLAS EYE GROUP LLC
Entity type:Organization
Organization Name:ATLAS EYE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:541-740-4942
Mailing Address - Street 1:226 E HISTORIC COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-2069
Mailing Address - Country:US
Mailing Address - Phone:503-492-3897
Mailing Address - Fax:503-665-4137
Practice Address - Street 1:226 E HISTORIC COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-2069
Practice Address - Country:US
Practice Address - Phone:503-492-3897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2674ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty