Lumiere LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LUMIERE LLC

Practice address

9120 NE Vancouver Mall Loop Ste 262
Vancouver, WA 98662-6391

Phone

(541) 702-7400

NPI assigned

Feb 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Opollo Ross, PSYDNPI 1477655454

Title

Clinical Director

Phone

(360) 602-2620

Specialties & licenses 1

Addresses

Other names 1

• Luminous Healthcare Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Opollo Ross, PSYD

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1477655454
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1124883160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 NE 63RD ST STE 277",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986611980",
            "telephone_number": "360-602-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 NE VANCOUVER MALL LOOP STE 262",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626391",
            "telephone_number": "541-702-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11905 NE 40th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986863152",
            "country_code": "US",
            "telephone_number": "360-602-2620",
            "fax_number": "360-553-1556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMIERE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "OPOLLO",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "360-602-2620",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luminous Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Luminous Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.