DAVID A WOLF OD LLC (NPI# 1750506937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750506937 |
| Entity Type | Organization |
| Organization Name | DAVID A WOLF OD LLC |
| Other Organization Name | LAKE OSWEGO VISION CLINIC |
| Practice Address |
15480 Boones Ferry Rd Lake Oswego OR 97035-3429 |
| Mailing Address |
4550 Kruse Way Suite 105 Lake Oswego OR 97035-3594 |
| Practice Telephone | 5036351458 |
| Mailing Telephone | 5036351458 |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | DAVID A. WOLF (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 5036351458 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1115355-6 | OR | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Dr David A. Wolf OD, Inc | Former Legal Business Name - Organization |
| Lake Oswego Vision Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4550 Kruse Way, Suite 105, Lake Oswego, OR 970353594 | 5036351458 |
| Street Address |
15480 BOONES FERRY RD |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-3429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861489874 | David A. Wolf | Optometrist | 15480 Boones Ferry Rd, Lake Oswego, OR 97035-3429 | 2005-10-04 |
| 1588014344 | Kyle Palmer | Optometrist | 15480 Boones Ferry Rd, Lake Oswego, OR 97035-3429 | 2016-06-13 |
| 1245483452 | Rachel Grace Horrocks | Optometrist | 15480 Boones Ferry Rd, Lake Oswego, OR 97035-3429 | 2008-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548519044 | Eyes of Oregon LLC | Optometrist | 2 Centerpointe Dr Ste 150, Lake Oswego, OR 97035-8637 | 2012-08-30 |
| 1861780785 | Kimberly Ann Schmidt | Optometrist | 333 S State St Ste T, Lake Oswego, OR 97034-3948 | 2011-07-12 |
| 1811026719 | Katherine Hess Phillips | Optometrist | 5335 Meadows Rd, Suite 151, Lake Oswego, OR 97035-3398 | 2007-03-05 |
| 1679636492 | David Anthony Biggar | Optometrist | 2 Centerpointe Dr, Suite 150, Lake Oswego, OR 97035-8618 | 2006-12-19 |
| 1841395449 | John Rumpakis | Optometrist | 5435 Southwood Dr, Lake Oswego, OR 97035-5780 | 2006-09-14 |
| 1528044807 | Daniel A. Robison, O.d., P.C. | Optometrist | 17777 Lwr Boones Fry Rd, Lake Oswego, OR 97035-5237 | 2005-12-19 |
| 1144204025 | Jeffrey H Garrett | Optometrist | 9 Monroe Pkwy Ste 160, Lake Oswego, OR 97035 | 2005-12-03 |
| 1760466015 | Shari L Mace | Optometrist | 4035 Mercantile Dr, Suite 216, Lake Oswego, OR 97035-2546 | 2005-11-30 |
| 1861489874 | David A. Wolf | Optometrist | 15480 Boones Ferry Rd, Lake Oswego, OR 97035-3429 | 2005-10-04 |
| 1487641080 | Daniel Allen Robison | Optometrist | 17777 Sw Lower Boones Ferry Rd, Lake Oswego, OR 97035-5398 | 2005-09-29 |
| Find all providers in LAKE OSWEGO | ||||
| City | LAKE OSWEGO |
| Zip Code | 97035 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.