Individual
LORI SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2480 NE FREMONT ST, PORTLAND, OR 97212-2509
(503) 284-3937
Mailing address
1430 NW HOYT ST APT 927, PORTLAND, OR 97209-2286
(301) 328-6494
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4620
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500805683
—
OR
Enumeration date
09/05/2019
Last updated
07/06/2022
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