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

Haley Kim, OD

Individual provider Optometrist · NPI 1104483833

Haley Kim, OD is an Optometry in Portland, Oregon. Graduated from Pacific University - College of Optometry in 2020, 6 years ago. Accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
6
Trained at
Pacific University - College of Optometry
Licensed in
OR
In the registry since
2019
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

4880 NE 104th Ave
Portland, OR 97220-3348
Phone: (503) 432-8452
Fax: (503) 432-8402
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence ATI4521 (OR)

Record details

NPI number1104483833
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedMay 29, 2019
Last updated in NPPESMay 22, 2024
Certification dateMay 22, 2024
Mailing address4880 Ne 104th Ave, Portland, OR 97220-3348

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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