Healthcare Provider Details

I. General information

NPI: 1174610331
Provider Name (Legal Business Name): D GREGORY LUCE OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14667 SW TEAL BLVD
BEAVERTON OR
97007-6194
US

IV. Provider business mailing address

14667 SW TEAL BLVD
BEAVERTON OR
97007-6194
US

V. Phone/Fax

Practice location:
  • Phone: 503-579-2020
  • Fax: 503-579-0404
Mailing address:
  • Phone: 503-579-2020
  • Fax: 503-579-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID GREGORY LUCE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 503-579-2020