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Contact Information

CONVERGE NEURO OPTOMETRY LLC
9975 SW FREWING ST STE 130
TIGARD, OR97223-5091
 Phone: 503-906-3596
 Fax: 503-906-1014
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Pediatrics

152WP0200X 41 Optometry
 

Sports Vision

152WS0006X 41 Optometry
 

Vision Therapy

152WV0400X 41 Optometry
Indicates primary specialty

NPI Profile & details for CONVERGE NEURO OPTOMETRY LLC

NPI Number 1427919729
LBN Legal business name CONVERGE NEURO OPTOMETRY LLC
Authorized official MACSON LEE - (CEO, OD, FOVDRA)
Entity Organization
Organization subpart 1 No
Enumeration date 11/18/2025
Last updated 11/18/2025 - About 7 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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