Healthcare Provider Details

I. General information

NPI: 1235179656
Provider Name (Legal Business Name): DEREK EDWARD LAMPRECHT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/22/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17355 LOWER BOONES FERRY RD SUITE 100A
LAKE OSWEGO OR
97035
US

IV. Provider business mailing address

17355 LOWER BOONES FERRY RD SUITE 100A
LAKE OSWEGO OR
97035
US

V. Phone/Fax

Practice location:
  • Phone: 503-224-8399
  • Fax: 503-224-5661
Mailing address:
  • Phone: 503-224-8399
  • Fax: 503-224-5661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO26679
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberDO26679
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: