Provider Demographics
NPI:1043769227
Name:WEST LINN VISION CENTER INC
Entity type:Organization
Organization Name:WEST LINN VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-548-2488
Mailing Address - Street 1:2020 8TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4657
Mailing Address - Country:US
Mailing Address - Phone:503-652-1479
Mailing Address - Fax:503-303-5587
Practice Address - Street 1:2020 8TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4657
Practice Address - Country:US
Practice Address - Phone:503-652-1479
Practice Address - Fax:503-303-5587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty