PARKROSE VISION, LLC (NPI# 1144847260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144847260 |
| Entity Type | Organization |
| Organization Name | PARKROSE VISION, LLC |
| Practice Address |
8136 Se Foster Rd Ste 260 Portland OR 97206-4288 |
| Mailing Address |
2512 Nw 12th Cir Camas WA 98607-8886 |
| Practice Telephone | 5035464460 |
| Mailing Telephone | 5099946264 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | DR. MARIELLE KWON (PRESIDENT) |
| Authorized Official Telephone | 5099946264 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | M. KWON. P.C., INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 2005056 | 05 |
| Other Name | Type Code |
|---|---|
| Foster Vision | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4880 Ne 104th Ave, Portland, OR 97220 | 5039430699 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PARKROSE VISION, LLC | 4880 Ne 104th Ave, Portland, OR 97220 |
| Street Address |
8136 SE FOSTER RD STE 260 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97206-4288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811472749 | Carole Tong | Optometrist | 8136 Se Foster Rd Ste 260, Portland, OR 97206-4288 | 2018-09-26 |
| 1104483833 | Haley Kim | Optometrist | 8136 Se Foster Rd Ste 260, Portland, OR 97206-4288 | 2019-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
| 1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
| 1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
| 1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
| 1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
| 1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
| 1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
| 1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
| 1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
| 1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
| Find all providers in zip 97206 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1679030290 | Yoana Kanev | Clinic/Center | 3701 Sw Condor Ave Apt C1, Portland, OR 97239-4158 | 2019-03-01 |
| 1841760584 | Orthopedic Needle LLC | Clinic/Center | 328 Ne Failing St Ste C, Portland, OR 97212-1157 | 2018-11-26 |
| 1073081881 | Sober Living Oregon Recovery Center | Clinic/Center | 1122 Ne 122nd Ave Ste A102, Portland, OR 97230-2082 | 2018-11-09 |
| 1366933830 | Dr Frances V Verzosa Md PC | Clinic/Center | 12770 Se Stark St Bldg C, Portland, OR 97233-1539 | 2018-05-21 |
| 1023520814 | Concordia Wellness, LLC | Clinic/Center | 3014 Ne Killingsworth St, Portland, OR 97211-6814 | 2017-11-01 |
| 1114443124 | Zephyr Acupuncture and Bodywork, LLC | Clinic/Center | 4313 Ne Tillamook St, Portland, OR 97213-1315 | 2017-08-22 |
| 1164952495 | Earth Source Medicine | Clinic/Center | 2207 Ne Broadway St Ste 200, Portland, OR 97232-1791 | 2017-06-19 |
| 1902353873 | Siesta Acupuncture LLC | Clinic/Center | 2818 Se 70th Ave, Portland, OR 97206-1117 | 2016-09-08 |
| Find all providers in PORTLAND | ||||
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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.