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Contact Information

NANCY BROCK, OD
13180 SE 169TH AVE STE 104
HAPPY VALLEY, OR97086
 Phone: 503-698-2375
 Fax: 503-698-3398
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Pediatrics

152WP0200X 41 Optometry
Indicates primary specialty

NPI Profile & details for NANCY BROCK · (Female)

NPI # 1447306360
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 01/25/2007
Last updated 03/26/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • OR License # 2628ATI
  • OR License # 2826ATI
  • Other R0000WDBCW MEDICARE GROUP PIN
  • Other 1508037607 ORGANIZATION (GROUP) NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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