Provider Demographics
NPI:1023152238
Name:SIGHTSEEING MOBILE EYE HEALTHCARE
Entity type:Organization
Organization Name:SIGHTSEEING MOBILE EYE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAD
Authorized Official - Middle Name:WILLIS
Authorized Official - Last Name:BUCKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-459-9247
Mailing Address - Street 1:7615 SW SPEAKS DR
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:OR
Mailing Address - Zip Code:97119-9117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7615 SW SPEAKS DR
Practice Address - Street 2:
Practice Address - City:GASTON
Practice Address - State:OR
Practice Address - Zip Code:97119-9117
Practice Address - Country:US
Practice Address - Phone:503-459-9247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4022 ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty