Provider Demographics
NPI:1033008222
Name:MANN, GURDAS (OD)
Entity type:Individual
Prefix:
First Name:GURDAS
Middle Name:
Last Name:MANN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2474 SE BURNSIDE RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-1247
Mailing Address - Country:US
Mailing Address - Phone:503-489-5771
Mailing Address - Fax:503-489-5778
Practice Address - Street 1:2474 SE BURNSIDE RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-1247
Practice Address - Country:US
Practice Address - Phone:503-489-5771
Practice Address - Fax:503-489-5778
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT4772152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist