Dr. Stacy Jo Hill, O.D.
Optometrist in Beaverton, OR. Individual provider (NPI-1).
NPI number1457765604
StatusActive
Last updated in NPPESDec 6, 2019
Details
- NPI
- 1457765604
- Entity type
- Individual (NPI-1)
- Name
- Dr. Stacy Jo Hill
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2014
- Last updated
- Dec 6, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 3548ATI | OR | Yes |
| 152WP0200X | Optometrist, Pediatrics | 3548ATI | OR | |
| 152WV0400X | Optometrist, Vision Therapy | 3548ATI | OR |
Other names
- Stacy Jo Koster (Former Name)
Practice location
4655 Sw Griffith Dr Ste 165Beaverton, OR 97005-8731
Phone 503-646-8592
Mailing address
4655 Sw Griffith Dr Ste 165Beaverton, OR 97005-8731
Phone 503-646-8592
Other practice locations
2043 College Way
Forest Grove, OR 97116-1797
Forest Grove, OR 97116-1797
Phone 503-352-2020
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All 41 Optometrist providers in Beaverton · All 4,562 providers in Beaverton
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