| Haley Kim, OD | |
| 4880 Ne 104th Ave, Portland, OR 97220-3348 | |
| (503) 432-8452 | |
| (503) 432-8402 | 
| Full Name | Haley Kim | 
|---|---|
| Gender | Female | 
| Speciality | Optometrist | 
| Location | 4880 Ne 104th Ave, Portland, Oregon | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1104483833 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 152W00000X | Optometrist | ATI4521 (Oregon) | Primary | 
| Provider Name | M Kwon Pc Inc | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1770727059 PECOS PAC ID: 4981745080 Enrollment ID: O20100112000443 | 
| Provider Name | Parkrose Vision, Llc | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1144847260 PECOS PAC ID: 6608277405 Enrollment ID: O20241114004575 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Haley Kim, OD 4880 Ne 104th Ave, Portland, OR 97220-3348 Ph: (503) 432-8452 | Haley Kim, OD 4880 Ne 104th Ave, Portland, OR 97220-3348 Ph: (503) 432-8452 | 
| Mrs. Ayla Jade Himmelsbach, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 7826 Sw Capitol Hwy, Portland, OR 97219 Phone: 503-224-7788 | |
| Eyedentity Vision Center P.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2609 Se Clinton St, Portland, OR 97202 Phone: 503-238-1139 Fax: 503-235-6574 | |
| On Sight Optical, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4542 Ne Martin Luther King Jr Blvd, Portland, OR 97211 Phone: 503-228-2154 Fax: 503-228-4694 | |
| Dr. Larry E Robertson, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 12100 Se Stevens Ct Ste 106, Portland, OR 97266 Phone: 503-653-1442 | |
| Dr. Kim M Clark & Associates Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 12000 Se 82nd Avenue, #2012, Portland, OR 97266 Phone: 503-652-6001 Fax: 503-652-6012 | |
| Dr. Laura Mae Armstrong, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2021 Ne Alberta St, Portland, OR 97211 Phone: 503-384-2489 Fax: 503-379-9488 | |
| Dr. Hayden Minh Nguyen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 8315 Se Stark St, Portland, OR 97216 Phone: 503-282-3070 Fax: 503-287-3482 |