Parkrose Vision, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PARKROSE VISION, LLC

Practice address

4880 NE 104TH Ave
Portland, OR 97220

Phone

(503) 943-0699

NPI assigned

Jul 6, 2020

Organization subpart

Yes

Parent organization

M. KWON. P.C., INC.As reported in NPPES

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

Authorized official

Name

Haley Kim, ODNPI 1104483833

Title

Owner

Phone

(503) 432-8452

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Part of

M Kwon PC Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• M. Kwon. P.C., Inc.

  • Optometrist
  • Portland, OR
  • NPI 1770727059
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Haley Kim, OD

  • Optometrist
  • Portland, OR
  • NPI 1104483833
  Medicare reassignment NPD Authorized official
• Alexandra Helling, OD

  • Optometrist
  • Fremont, CA
  • NPI 1821752155

  OR

  Medicare reassignment NPD
• Lana Ngoc Lan Trinh, O.D.

  • Optometrist
  • Portland, OR
  • NPI 1780969832
  NPD (past)

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1144847260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15470 SE BADEN POWELL RD",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970866049",
            "telephone_number": "503-819-1807",
            "fax_number": "503-432-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 NE 104TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-943-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKROSE VISION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "M. KWON. P.C., INC.",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HALEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-432-8452",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500784142",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Parkinson, LCSW, CADC-I
• John Marcel Parkison, RPH
• Parkrose Chiropractic, PC
• Parkrose Family Dental (Roseway Family Dental)
• Parkrose Family Dentistry, P.C.
• Brandon Parks
• Deanna Rae Parks
• Emma Diane Parks, CRM
• Gina Parks
• Melissa Parks

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.