DR. GERALD T. LISAC M.D.
NPI 1003950684
Specialist in West Linn, OR

Q: What is Gerald Lisac's NPI number?

The NPI number for Gerald Lisac is 1003950684. It was assigned to this individual provider in the NPPES registry on February 16, 2007.

Q: What is Gerald Lisac's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Gerald Lisac was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 16, 2007

276 SW FOREST COVE RD, WEST LINN, OR 97068(503) 557-3679(503) 557-3680 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Gerald T. Lisac M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GERALD T. LISAC M.D. (NPI 1003950684) is an individual specialist in West Linn, Oregon, licensed in Oregon (MD06539) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1003950684

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. GERALD T. LISACCredential: M.D.

Location Address276 SW FOREST COVE RDWest Linn, OR 97068-9401

Mailing AddressPo Box 646West Linn, OR 97068-0646 · (503) 557-3679 · Fax (503) 557-3680

Phone(503) 557-3679

Fax(503) 557-3680

Sole ProprietorYes

Enumeration DateFebruary 16, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1003950684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in OR · MD06539

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

276 SW FOREST COVE RD, West Linn, OR 97068

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Other Identifiers 3

OtherD72976OR · Prov. Health Plan

Medicare ID-Type Unspecified0000BLBPROR · Provider Number

Medicaid107722OR

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gerald Lisac's NPI number?

The NPI number for Gerald Lisac is 1003950684. It was assigned to this individual provider in the NPPES registry on February 16, 2007.

Where is Gerald Lisac located?

Gerald Lisac practices at 276 SW Forest Cove Rd, West Linn, OR 97068. The listed phone number is (503) 557-3679.

What is Gerald Lisac's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Gerald Lisac was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.