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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
11086 SE OAK ST, MILWAUKIE, OR 97222-6692
(503) 656-4221
(503) 656-4249
Mailing address
PO BOX 22009, MILWAUKIE, OR 97269-2009
(503) 558-7372
(503) 344-5110

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085006
OR
Enumeration date
10/06/2009
Last updated
02/20/2021
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