Organization
PARKROSE VISION, LLC
Active
Parent organization
M. KWON. P.C., INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
M. KWON. P.C., INC.
Authorized official
HALEY KIM OD (OWNER)
(503) 432-8452
Entity
Organization
Contact information
Practice address
4880 NE 104TH AVE, PORTLAND, OR 97220
(503) 943-0699
Mailing address
15470 SE BADEN POWELL RD, HAPPY VALLEY, OR 97086-6049
(503) 819-1807
(503) 432-8402
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500784142
—
OR
Enumeration date
07/06/2020
Last updated
05/22/2024
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