Individual
HALEY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4880 NE 104TH AVE, PORTLAND, OR 97220-3348
(503) 432-8452
(503) 432-8402
Mailing address
4880 NE 104TH AVE, PORTLAND, OR 97220-3348
(503) 432-8452
(503) 432-8402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4521
OR
Other
Enumeration date
05/29/2019
Last updated
05/22/2024
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