Dr. Kim M Clark & Associates LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2911ATI Issued in OR

Legal business name

DR. KIM M CLARK & ASSOCIATES LLC

Practice address

12000 SE 82ND Avenue
#2012
Portland, OR 97266-7721

Phone

(503) 652-6001

Fax

(503) 652-6012

NPI assigned

May 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kim M Clark, OD

Title

Owner

Phone

(503) 292-4033

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1013141696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 NW EDGEWOOD PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297618",
            "telephone_number": "503-292-4033",
            "fax_number": "503-292-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 SE 82ND AVENUE",
            "address_2": "#2012",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972667721",
            "telephone_number": "503-652-6001",
            "fax_number": "503-652-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KIM M CLARK & ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-292-4033",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2911ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Hayley Jensen LLC
• Dr. Jessica Sweet, ND, Lac LLC
• Dr. Jonna E. Hongo
• Dr. Kacy Borba, LLC
• Dr. Karen Cureton ND, Lac
• Dr. Lana Trinh & Associates, LLC
• Dr. Lu'S Acupunture & Massage Clinic, LLC
• Dr. Mary Caselli PC
• Dr. Monica Kendall LLC
• Dr. Montserrat Andreys LLC

• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.