Healthcare Provider Details

I. General information

NPI: 1811016215
Provider Name (Legal Business Name): MAYRON M YIP-NG PT, MTC, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOOI Y YIP

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 NW 29TH ST
CORVALLIS OR
97330
US

IV. Provider business mailing address

2865 NW 29TH ST
CORVALLIS OR
97330-3516
US

V. Phone/Fax

Practice location:
  • Phone: 540-752-0083
  • Fax:
Mailing address:
  • Phone: 541-243-8199
  • Fax: 541-286-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number60289
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: