Katlyn Rene Peterson
OD | Optometrist | 6+ years Exp
Medicare Enrolled 921 Sw 16th Ave, Portland
Oregon, 97205-1730
503-227-0573 503-227-0509
Maps & DirectionsKatlyn Rene Peterson is a Portland, Oregon based Optometrist with 6 years of experience in Optometry. She completed her graduation from University Of Missouri St Louis - School Of Optometry in 2020. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Katlyn Rene Peterson is ATI4633 for Optometry in Oregon.
Katlyn Rene Peterson examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. She completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. She is a eye health care professional who is state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Profile:
Katlyn Rene Peterson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Specialization: | Optometry |
| Credentials: | OD |
| Experience: | 6+ years |
| Medical School Attended: | University Of Missouri St Louis - School Of Optometry |
| Graduation Year: | 2020 |
| Gender: | Female |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 921 Sw 16th Ave, Portland,
Oregon, 97205-1730 |
| Phone: | 503-227-0573 |
| Fax: | 503-227-0509 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 5193138329 |
| Enrollment ID: | I20220621001784 |
| NPI Number: | 1538768007 |
| NPI Enumeration Date: | 25 Oct, 2020 |
| NPI Last Update On: | 27 Aug, 2026 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Katlyn Rene Peterson are as mentioned below.
| License Number | Specialization | State | Status | |
| ATI4633 | Optometry | Oregon | Primary | |
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Katlyn Rene Peterson has association with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Eye Health Northwest Pc (9234039926) | 64 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Katlyn Rene Peterson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 500807355 | Medicaid | Oregon | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 921 Sw 16th Ave,
Portland, Oregon |
| Zip: | 97205-1730 |
| Phone Number: | 503-227-0573 |
Patients can reach Katlyn Rene Peterson at
921 Sw 16th Ave, Portland, Oregon or can
call to book an appointment on 503-227-0573.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 September, 2026.