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Organization
EYE HEALTH NORTHWEST P.C.
Active
Organization
EYE HEALTH NORTHWEST P.C.
Active
Parent organization
EYE HEALTH NORTHWEST P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE HEALTH NORTHWEST P.C.
Authorized official
DR. SHANE K KIM M.D. (PRESIDENT)
(503) 255-2291
Entity
Organization
Contact information
Practice address
3246 N LOMBARD ST, PORTLAND, OR 97217-1206
(503) 285-1671
(503) 285-7859
Mailing address
PO BOX 22009, MILWAUKIE, OR 97269-2009
(503) 558-7372
(503) 344-5140
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085006
—
OR
Enumeration date
09/29/2009
Last updated
02/20/2021
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