Provider Demographics
NPI:1902245574
Name:OOLEY, CAROLINE MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MARIE
Last Name:OOLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:CAROLINE
Other - Middle Name:MARIE
Other - Last Name:SLAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10510 SW BUTNER RD APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10510 SW BUTNER RD APT 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5236
Practice Address - Country:US
Practice Address - Phone:858-401-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3496ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist