Provider Demographics
NPI:1811935331
Name:LAUKKANEN, HANNU ROBERT VILJO (OD)
Entity type:Individual
Prefix:DR
First Name:HANNU
Middle Name:ROBERT VILJO
Last Name:LAUKKANEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:HANNU
Other - Middle Name:ROBERT VILJO
Other - Last Name:LAUKKANEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2043 COLLEGE WAY
Mailing Address - Street 2:PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-1756
Mailing Address - Country:US
Mailing Address - Phone:503-352-2751
Mailing Address - Fax:503-352-2929
Practice Address - Street 1:2043 COLLEGE WAY
Practice Address - Street 2:PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-1756
Practice Address - Country:US
Practice Address - Phone:503-352-2751
Practice Address - Fax:503-352-2929
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1599TX152W00000X
OR1706ATI152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR034830Medicaid
OR034830Medicaid