Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marcy G Lake, DO

Individual provider Family Medicine Physician · NPI 1174550123

Marcy G Lake, DO is a Family Practice in Beaverton, Oregon. Graduated from Midwestern University, Chicago College of Osteopathic Med in 2006, 20 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
20
Trained at
Midwestern University, Chicago College of Osteopathic Med
Licensed in
OR
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4855 SW Western Ave
Beaverton, OR 97005-3460
Phone: (503) 813-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence DO173074 (OR)

Record details

NPI number1174550123
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedJune 27, 2006
Last updated in NPPESDecember 30, 2015
Mailing address4855 Sw Western Ave, Beaverton, OR 97005-3460

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolMIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated 2006 (20 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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