LAKE OSWEGO VISION CLINIC LLC
NPI 1750506937
Optometrist in Lake Oswego, OR
NPI Status: Active since April 14, 2007
Contact Information
15480 BOONES FERRY RD
LAKE OSWEGO, OR
ZIP 97035
Phone: (503) 635-1458
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Optometrist
- Accepts Insurance
- CLIA Number: 38D2019999
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-12-2026
About LAKE OSWEGO VISION CLINIC LLC
This page provides the complete NPI Profile along with additional information for Lake Oswego Vision Clinic Llc, a provider established in Lake Oswego, Oregon operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1750506937 assigned on April 2007. The practitioner's primary taxonomy code is 152W00000X with license number 1115355-6 (OR). The provider is registered as an organization and their NPI record was last updated July 2025. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's
- NPI
- 1750506937
- Provider Legal Name
- LAKE OSWEGO VISION CLINIC LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 15480 BOONES FERRY RD LAKE OSWEGO, OR 97035
- Location Phone
- (503) 635-1458
- Mailing Address
- 15480 BOONES FERRY RD LAKE OSWEGO, OR 97035
- Mailing Phone
- (503) 635-1458
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-14-2007
- Last Update Date
- 07-10-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 1115355-6
- License State
- OR
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists 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. An optometrist has 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. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B07S HSA - EPO
- BlueCross B15S $0 virtual care from Teladoc Health � - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Navigator Bronze 7000 Exchange - PPO
- Navigator Bronze 9200 - PPO
- Navigator Bronze HSA 8050 - PPO
- Navigator Gold 1500 - PPO
- Navigator Gold 1500 Exchange - PPO
- Navigator Gold 500 Exchange - PPO
- Navigator Silver 3500 Exchange - PPO
- Navigator Silver 4000 Exchange - PPO
- Navigator Silver 5000 - PPO
- Navigator Silver HSA 3500 - PPO
- Navigator Standard Expanded Bronze - PPO
- Navigator Standard Gold - PPO
- Navigator Standard Silver - PPO
- PacificSource Oregon Standard Bronze Plan NAV - PPO
- PacificSource Oregon Standard Gold Plan NAV - PPO
- PacificSource Oregon Standard Silver Plan NAV - PPO
- Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
- Bronze HSA 7000 Individual and Family Network - EPO
- Gold 2300 Individual and Family Network - EPO
- Regence Standard Bronze Plan Individual and Family Network - EPO
- Regence Standard Gold Plan Individual and Family Network - EPO
- Regence Standard Silver Plan Individual and Family Network - EPO
- Silver 6200 Individual and Family Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D2019999
- Facility Type
- Physician Office
- Certificate Effective Date
- February 13, 2024
- Certificate Expiration Date
- February 12, 2026
- Laboratory Director
- DAVID A WOLF OD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lake Oswego Vision Clinic Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LAKE OSWEGO VISION CLINIC LLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 5 | 0 | 6 | 9 | 3 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 10 | 0 | 12 | 9 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 0 + 0 + 1 + 2 + 9 + 6 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1750506937 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
DAVID A. WOLF O.D.
Optometrist
15480 BOONES FERRY RD
LAKE OSWEGO, OR
ZIP 97035
RACHEL GRACE HORROCKS O.D.
Optometrist
15480 BOONES FERRY RD
LAKE OSWEGO, OR
ZIP 97035
KYLE PALMER
Optometrist
15480 BOONES FERRY RD
LAKE OSWEGO, OR
ZIP 97035
DR. JOSEPH NERON OD
Optometrist
15480 BOONES FERRY RD
LAKE OSWEGO, OR
ZIP 97035
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750506937, enumerated as an "organization" on April 14, 2007.
The provider is located at 15480 BOONES FERRY RD LAKE OSWEGO, OR 97035 and the phone number is (503) 635-1458.
Optometrist with taxonomy code 152W00000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, BridgeSpan. Please consult your insurance carrier or call the provider to verify.
