Healthcare Provider Details
I. General information
NPI: 1831023944
Provider Name (Legal Business Name): LUKE ANDREW BRINTON OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6375 ULALI DR NE
KEIZER OR
97303-1697
US
IV. Provider business mailing address
1433 NE ALEX WAY APT 341
HILLSBORO OR
97124-8608
US
V. Phone/Fax
- Phone: 503-428-5096
- Fax:
- Phone: 208-870-2953
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | AT4828 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: