NPIMap

Organization Active NPI

Double Vision Inc

  • Optometrist
  • Happy Valley, OR
National Provider Identifier
1508037607
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1749ATI Issued in OR
Legal business name
DOUBLE VISION INC
Practice address
13180 SE 169TH Ave Ste 104
Happy Valley, OR 97086
Phone
(503) 698-2375
Fax
(503) 698-3398
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Authorized official

Name
Dr. William B Berk, O.D.NPI 1275630808
Title
Owner
Phone
(503) 698-2375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1749ATI OR Primary

Addresses

Primary practice location

13180 SE 169TH Ave Ste 104
Happy Valley, OR 97086

Mailing address

13180 SE 169TH Ave Ste 104
Happy Valley, OR 97086-8727
Phone (503) 698-2375

Other names 1

  • Happy Valley Vision Source Doing business as

National Provider Directory

National Provider Directory

Locations

12018 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 698-2375

12020 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 698-2375

2020 NE 102nd Ave
Portland, OR 97220
Phone (503) 252-2375

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1508037607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13180 SE 169TH AVE STE 104",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970868727",
            "telephone_number": "503-698-2375",
            "fax_number": "503-698-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13180 SE 169TH AVE STE 104",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "97086",
            "telephone_number": "503-698-2375",
            "fax_number": "503-698-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUBLE VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "BERK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-698-2375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1749ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Happy Valley Vision Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Happy Valley, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.