DR. KELVIN KIU WING SO (NPI# 1053646133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053646133 |
| Entity Type | Individual |
| Full Name | DR. KELVIN KIU WING SO |
| Credential | O.D. |
| Practice Address |
2043 College Way Forest Grove OR 97116-1756 |
| Mailing Address |
2543 Nw Overlook Dr Apt 127 Hillsboro OR 97124-7606 |
| Practice Telephone | 5038801381 |
| Mailing Telephone | 5038801381 |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2011-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 3414ATI | OR | Eye and Vision Services Providers |
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
3414ATI | OR | Eye and Vision Services Providers |
| Street Address |
2043 COLLEGE WAY |
| City | FOREST GROVE |
| State | OR |
| Zip Code | 97116-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962492595 | Kenneth Warren Eakland | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2005-10-25 |
| 1972102796 | Jonathan T Bloemers | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2020-10-22 |
| 1457979080 | Maud Darger | Student in an Organized Health Care Education/Training Program | 2043 College Way, Forest Grove, OR 97116-1797 | 2020-07-09 |
| 1881226249 | Caitlin Odonnell | Specialist/Technologist | 2043 College Way, Forest Grove, OR 97116-1756 | 2020-02-04 |
| 1386292852 | Pacific University | Optometrist | 2043 College Way, Forest Grove, OR 97116-1797 | 2019-08-28 |
| 1447813563 | Mari Jalene Fujimoto | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2019-04-15 |
| 1043776024 | Abigail Carpenter | Specialist/Technologist | 2043 College Way, Forest Grove, OR 97116-1756 | 2019-02-14 |
| 1194294108 | Julia Le Lieu | Student in an Organized Health Care Education/Training Program | 2043 College Way, Forest Grove, OR 97116-1797 | 2018-11-19 |
| 1083192488 | Rachael Leeann Wilson | Physician Assistant | 2043 College Way, Forest Grove, OR 97116-1756 | 2018-07-30 |
| 1154807295 | Sarah Rothley Lucas | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2018-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780220988 | Jenny Park | Social Worker | 2023 Hawthorne Street, Building C, Forest Grove, OR 97116 | 2019-11-22 |
| 1447742077 | Kimberly K Sabin | Doula | 1239 Goff Rd, Forest Grove, OR 97116 | 2018-05-30 |
| 1891205266 | Sonam Narayan | Optometrist | 2221 Pacific Avenue, Forest Grove, OR 97116 | 2017-10-11 |
| 1013260181 | Sharon Louise Benjamin | Nurse Practitioner | 2724 Harvest Ct, Forest Grove, OR 97116 | 2012-10-25 |
| 1336445535 | Shane Michael Peterson | Physical Therapist | 3300 19th Avenue, Forest Grove, OR 97116 | 2011-02-04 |
| 1023324415 | Kara Marie Cooper | Registered Nurse | 2221 Oak St, Forest Grove, OR 97116 | 2010-08-24 |
| 1811229792 | Rachel Lucinda Erin Dilly | Speech-Language Pathologist | 3300 19th Ave., Forest Grove, OR 97116 | 2010-02-03 |
| 1720286339 | Thuymai Anna Fee | Physical Therapist | Custom Care Physical Therapy, 4150 Pacific Ave. #100, Forest Grove, OR 97116 | 2007-07-05 |
| 1629102454 | Lois Elizabeth Yevdalcia Dimick | Massage Therapist | 2004 Main St, Suite 204, Forest Grove, OR 97116 | 2007-03-15 |
| 1023159936 | Ninette Kay Foster | Contractor | 2329 Pacific Ave., Forest Grove, OR 97116 | 2007-02-12 |
| Find all providers in zip 97116 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649764879 | Emily Cheng | Optometrist | 2043 College Way, Forest Grove, OR 97116-1797 | 2018-06-20 |
| 1952347239 | Jennifer Lee Coyle | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2006-06-22 |
| 1063403798 | Beth Toshiko Kinoshita | Optometrist | 2043 College Way, Forest Grove, OR 97116-1756 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083246292 | Gatti Vision LLC | Optometrist | 15405 Sw 116th Ave Ste 204, King City, OR 97224-4101 | 2020-02-05 |
| 1194355123 | Irina Stignei Od PC | Optometrist | 1433 Ne 69th Ave, Portland, OR 97213-5301 | 2020-01-17 |
| 1295158301 | Oizu Optic LLC | Optometrist | 4133 Se Division St, Portland, OR 97202-1646 | 2014-01-24 |
| 1962641654 | Mt Scott Vision and Ocular Imaging Center PC | Optometrist | 9300 Ne 91st Ave, Suite 100, Happy Valley, OR 97086 | 2009-02-19 |
| 1396814091 | Craig E Bowen | Optometrist | 18801 Sw Boones Ferry Rd, Tualatin, OR 97062-8412 | 2006-11-07 |
| 1225125503 | Shauna R. Schissler, Od and Associates, PC | Optometrist | 970 Nw Eastman Pkwy, Gresham, OR 97030-5533 | 2006-10-06 |
| 1992798136 | Donald J Johnson Od PC | Optometrist | 635 Thornton Way, Ashland, OR 97520-4500 | 2005-08-23 |
| 1972508596 | Gerald R Starchvick | Optometrist | 1251 E Mcandrews Rd, Suite 100, Medford, OR 97504-6497 | 2005-06-20 |
| 1942737473 | Kelly Voltz | Optometrist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2017-05-15 |
| 1659721280 | Brooke Morris Harkness | Optometrist | 15298 Sw Royalty Pkwy, Tigard, OR 97224-3904 | 2016-06-14 |
| Find all providers with the same taxonomy | ||||
| City | FOREST GROVE |
| Zip Code | 97116 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.