Provider Demographics
NPI:1770069650
Name:PAIGE, YUME KIM (OD)
Entity type:Individual
Prefix:DR
First Name:YUME
Middle Name:KIM
Last Name:PAIGE
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:DUNG
Other - Middle Name:KIM
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:13180 SE 169TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-8727
Mailing Address - Country:US
Mailing Address - Phone:503-698-2375
Mailing Address - Fax:503-251-3761
Practice Address - Street 1:13180 SE 169TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-8727
Practice Address - Country:US
Practice Address - Phone:503-698-2375
Practice Address - Fax:503-251-3761
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORATI4553152W00000X
CAOPT34051-TLG152W00000X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics