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NPI Code Detail

MEDICARE: JERRY YALE JR. MD

MEDICARE: JERRY YALE JR. MD
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
1207Q00000XFamily Medicine Physician66396TN
2207Q00000XFamily Medicine PhysicianC5634KY
3207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianMD167386OR
4207Q00000XFamily Medicine PhysicianMD167386OR
5207Q00000XFamily Medicine Physician2007-01061NC

General Provider Information

NPI Number : 1669586442
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY YALE JR. MD
Provider Business Mailing Address
First Line : 1175 MOUNT HOOD AVE
Second Line :
City : WOODBURN
State : OR
Zip : 97071-9060
Country : US
Telephone Number : 503-982-2000
Fax Number : 503-982-0660
Provider Business Practice Location Address
First Line : 1175 MOUNT HOOD AVE
Second Line :
City : WOODBURN
State : OR
Zip : 97071-9060
Country : US
Telephone Number : 503-982-2000
Fax Number : 503-982-0660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 06/05/2026

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