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General NPI Number Information
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NPI Number | 1164875977
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Entity Type | Individual
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Provider Name | DAYNA YIM O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2016
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Last Update Date | 07/16/2016
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Provider Practice Location Address
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Address Line | 1107 NE 9TH AVE APT #325
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City | PORTLAND
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State | OR
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Zip | 97232-3629
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Country | US
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Telephone | 808-222-5305
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Fax |
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Provider Business Mailing Address
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Address Line | 3059 MAIGRET ST
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City | HONOLULU
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State | HI
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Zip | 96816-1930
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Country | US
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Telephone | 808-222-5305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3673AT
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD843
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License Number State | HI
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