MEDICARE: DR. LORNE YUDCOVITCH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	2588AT	OR
2	152WP0200X	Pediatric Optometrist	2588AT	OR
3	152W00000X	Optometrist	2588AT	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	300200803	OTHER		BC HMO/FC 65
3	2588AT	OTHER	OR	STATE OPTOMETRY LICENSE #
4	5255690001	OTHER		DMERC
5	831474004	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1487645586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORNE YUDCOVITCH O.D.

Provider Business Mailing Address
First Line	:	22165 NE FRYER HILL RD
Second Line	:
City	:	DUNDEE
State	:	OR
Zip	:	97115-9179
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2043 COLLEGE WAY
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-1756
Country	:	US
Telephone Number	:	503-352-2781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	04/13/2020

Similar Medicare Providers

1275390650 — NATHAN ALAN PATTERSON O.D.
Practice Location Address:

2221 PACIFIC AVENUE
FOREST GROVE, OR
97116-1756

Practice Phone: 503-352-2020
Practice Fax:

1962492595 — DR. KENNETH WARREN EAKLAND O.D.
Practice Location Address:

2043 COLLEGE WAY
FOREST GROVE, OR
97116-1756

Practice Phone: 503-352-2193
Practice Fax: 503-352-2929

1578554523 — JOHN PATRICK LOWERY O.D.
Practice Location Address:

2043 COLLEGE WAY
FOREST GROVE, OR
97116-1756

Practice Phone: 503-352-3139
Practice Fax: 503-352-2261

1407847445 — DR. CAROL Z RYMER O.D.
Practice Location Address:

2043 COLLEGE WAY
FOREST GROVE, OR
97116-1756

Practice Phone: 503-352-2020
Practice Fax: 503-352-2261

1063403798 — DR. BETH TOSHIKO KINOSHITA O.D.
Practice Location Address:

2043 COLLEGE WAY
FOREST GROVE, OR
97116-1756

Practice Phone: 503-352-3140
Practice Fax: 503-352-2929

1982695524 — DR. JOHN WILFRED RANDALL OD, MPH
Practice Location Address:

2043 COLLEGE WAY , PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY
FOREST GROVE, OR
97116-1756

Practice Phone: 503-352-2020
Practice Fax: 503-352-2929

Directions to “ DR. LORNE YUDCOVITCH O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.