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
6111 NE CORNELL RD, HILLSBORO, OR 97124-5410
(503) 846-9400
(503) 846-9500
Mailing address
11086 SE OAK ST, PORTLAND, OR 97222-6692
(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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