Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kim M Clark, OD

Individual provider Optometrist · NPI 1215091095

Dr. Kim M Clark, OD is an Optometrist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2006.

Licensed in
OR
In the registry since
2006
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

12000 SE 82nd Ave #2012
Portland, OR 97266-7721
Phone: (503) 652-6001
Fax: (503) 652-6012
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2911ATI (OR)

Record details

NPI number1215091095
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedDecember 19, 2006
Last updated in NPPESMay 11, 2009
Mailing address2318 Nw Edgewood Pl, Portland, OR 97229-7618

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