Cleveland, Trevor John
Cleveland, Trevor John is an individual health care provider with primary practice located at 840 A St , Springfield OR 97477-4710. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cleveland, Trevor John can be contacted via phone (541) 747-0616.Contact Information
Primary practice address
840 A St
Springfield OR 97477-4710
Phone: (541) 747-0616
Fax: (541) 747-0617
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2697ATI | Oregon |
Profile Details
| NPI number | 1407812480 |
|---|---|
| LBN Legal business name | Cleveland, Trevor John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Jan 2nd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407812480 | NPPES |
| Oregon | MEDICAID | 208294 | |
| Oregon | Other | 3011 |
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