NPI 1013141696

Dr. Kim M Clark & Associates LLC

Organisation Optometrist Portland, OR

Practice location

Address: 12000 SE 82nd Avenue #2012, Portland, OR 97266-7721
Phone: (503) 652-6001
Fax: (503) 652-6012
Mailing address: 2318 NW Edgewood Pl, Portland, OR 97229-7618

Authorised official

Name: Kim M Clark
Title: Owner
Phone: (503) 292-4033

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2911ATI (OR)

Other Optometrist providers in Oregon →

Registry record

NPI: 1013141696
Entity type: Organization
NPI issued: 11 May 2009
Record last updated: 11 May 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.