Healthcare Provider Details

I. General information

NPI: 1285519884
Provider Name (Legal Business Name): ALEXIS CHYI KHAUV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 SW BARNES RD STE 961
PORTLAND OR
97225-6699
US

IV. Provider business mailing address

9135 SW BARNES RD STE 961
PORTLAND OR
97225-6699
US

V. Phone/Fax

Practice location:
  • Phone: 503-292-0848
  • Fax: 503-296-0635
Mailing address:
  • Phone: 503-292-0848
  • Fax: 503-296-0635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4833ATI
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: