NPI 1255419271 · live from the CMS NPI Registry
Allicia Kim Beach, OD
Optometrist in Portland, OR. National Provider Identifier 1255419271, active.
NPI record
| NPI | 1255419271 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 3600 N Interstate Ave, Portland, OR 97227 |
| Practice phone | 800-813-2000 |
| Mailing address | 500 Ne Multnomah St Fl 11, Portland, OR 97232 |
| Enumerated | November 1, 2006 |
| Last updated | November 4, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | OD00004019 (WA) |
| Optometrist primary | 152W00000X | 3328 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.