Provider Demographics
NPI:1548946742
Name:VISION PERFORMANCE OF OREGON LLC
Entity type:Organization
Organization Name:VISION PERFORMANCE OF OREGON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHUN-NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-690-2020
Mailing Address - Street 1:1500 SW 11TH AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-3532
Mailing Address - Country:US
Mailing Address - Phone:503-516-7989
Mailing Address - Fax:
Practice Address - Street 1:7129 NE IMBRIE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7594
Practice Address - Country:US
Practice Address - Phone:503-690-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty