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
—
—
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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