Luke Boran, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

70010268 Issued in WA

Practice address

209 W Main St Ste 100
Kelso, WA 98626-1368

Phone

(360) 414-8000

Fax

(360) 414-1100

NPI assigned

Jun 19, 2023

Last updated

Oct 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Rivers Eye Care PSGroup PAC ID 9335260231, 2 clinicians

Lifetime Vision Source of Lebanon LLCGroup PAC ID 6608773148, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Three Rivers Eye Care, PS

  • Optometrist
  • Kelso, WA
  • NPI 1104094143
  Medicare reassignment Care Compare group NPD
• Lifetime Vision Source of Lebanon LLC

  • Optometrist
  • Lebanon, OR
  • NPI 1710168877
  Medicare reassignment Care Compare group NPD
• Mountain View Eye Care Center P C

  • Optometrist
  • Vancouver, WA
  • NPI 1093035305
  Medicare reassignment NPD
• Eyecare Associates PC

  • Ophthalmology Physician
  • Albany, OR
  • NPI 1013964113

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1386329290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 89",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986260102",
            "telephone_number": "360-414-8000",
            "fax_number": "360-414-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST STE 100",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986261368",
            "telephone_number": "360-414-8000",
            "fax_number": "360-414-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORAN",
        "first_name": "LUKE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "70010268",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4686ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Lynn Birtchet, CDPT
• Tina Black
• Amanda Bloomfeldt, CM/CC
• Rene Kerry Bohannon-Oxford, LMHC
• Nicole Francoise Bolender, M.D.
• Mark L Bradbury, MA, LMFTA
• Allison Brault
• Hannah Brewer, LPN
• Melissa Brinkerhoff, NP
• Jordan Lee Brooks, MS MHCA SUDP CPC

• Optometrist in Kelso, WA
• Providers in Kelso, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.