Provider Demographics
NPI:1447247440
Name:ROBBINS-LUCE, DIANE (OD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:ROBBINS-LUCE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14667 SW TEAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6194
Mailing Address - Country:US
Mailing Address - Phone:503-579-2020
Mailing Address - Fax:503-579-0404
Practice Address - Street 1:14667 SW TEAL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6194
Practice Address - Country:US
Practice Address - Phone:503-579-2020
Practice Address - Fax:503-579-0404
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2236T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
R0000WCNHGMedicare PIN
ORU14044Medicare UPIN