Kelvin Kiu Wing So, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

3414ATI Issued in OR

Practice address

2043 College Way
Forest Grove, OR 97116-1756

Phone

(503) 880-1381

NPI assigned

Oct 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1053646133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2543 NW OVERLOOK DR APT 127",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247606",
            "telephone_number": "503-880-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-880-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "KELVIN",
        "middle_name": "KIU WING",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "3414ATI",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3414ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Smith, PA
• Deborah Smith
• John Alexander Smith, O.D.
• Michelle Smith, PSYD
• Norman Smith
• Jaclyn Sorbets
• Paul E Sorenson, LCSW
• Karen Anne Sotto, L.M.T.
• Jamison Riley Soupir, OD
• Timothy Allen Speck, O.D.

• Corneal and Contact Management Optometrist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Corneal and Contact Management Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.