MEDICARE: MR. ORLIN HAROLD YODER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	076036012RN	OR

General Provider Information

NPI Number	:	1518125012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ORLIN HAROLD YODER RN

Provider Business Mailing Address
First Line	:	5800 SW VERMONT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97219-1041
Country	:	US
Telephone Number	:	503-504-3005
Fax Number	:

Provider Business Practice Location Address
First Line	:	11000 SW BARBUR BLVD
Second Line	:	SUITE 100
City	:	PORTLAND
State	:	OR
Zip	:	97219-8691
Country	:	US
Telephone Number	:	503-452-7979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	05/30/2008

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