Provider Demographics
NPI:1861921702
Name:LEDER, CHRISTOPHER AARON (OD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:LEDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 VALLEY RIVER CTR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2124
Mailing Address - Country:US
Mailing Address - Phone:541-687-8666
Mailing Address - Fax:
Practice Address - Street 1:400 VALLEY RIVER CTR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2124
Practice Address - Country:US
Practice Address - Phone:541-687-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4427AT152W00000X
UT10388286-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist