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Individual

WILLIAM D VANDECAR IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9 MONROE PARKWAY, SUITE 160, LAKE OSWERGO, OR 97035
(503) 636-2551
(503) 636-3055
Mailing address
PO BOX 22009, PORTLAND, OR 97269
(503) 558-7372
(503) 344-5140

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD228671
OR
207W00000X
Ophthalmology Physician
MD61417092
WA
390200000X
Student in an Organized Health Care Education/Training Program
8219851
WI

Other

Enumeration date
05/03/2015
Last updated
02/06/2026
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