Provider Demographics
NPI:1326023821
Name:SCOTT L. NEHRING, O.D., P.C.
Entity Type:Organization
Organization Name:SCOTT L. NEHRING, O.D., P.C.
Other - Org Name:WOODBURN VISION SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:NEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-982-3937
Mailing Address - Street 1:590 GLATT CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-9675
Mailing Address - Country:US
Mailing Address - Phone:503-982-3937
Mailing Address - Fax:503-982-5438
Practice Address - Street 1:590 GLATT CIR
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9675
Practice Address - Country:US
Practice Address - Phone:503-982-3937
Practice Address - Fax:503-982-5438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1650AT152W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287597Medicaid
ORDD1809OtherMEDICARE RAILROAD
OR858259000OtherREGENCE BLUE CROSS BLUE S
OR5671920001Medicare NSC
ORT67947Medicare UPIN