Provider Demographics
NPI:1861526980
Name:RIMKEIT, CYNTHIA (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:RIMKEIT
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 1:6420 SW MACADAM AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3507
Mailing Address - Country:US
Mailing Address - Phone:503-244-8601
Mailing Address - Fax:503-244-3013
Practice Address - Street 1:9135 SW BARNES RD
Practice Address - Street 2:SUITE 961
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6646
Practice Address - Country:US
Practice Address - Phone:503-292-0848
Practice Address - Fax:503-296-0635
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12098T152W00000X
OR3249T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500650432Medicaid
ORR167411Medicare PIN
ORR167410Medicare PIN
ORR167598Medicare PIN
OR500650432Medicaid