Healthcare Provider Details

I. General information

NPI: 1679586994
Provider Name (Legal Business Name): YOGI INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 11/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 NW SAMARITAN DRIVE
CORVALLIS OR
97330
US

IV. Provider business mailing address

5800 NW PRIMINO AVE
PORTLAND OR
97229
US

V. Phone/Fax

Practice location:
  • Phone: 541-754-1284
  • Fax: 541-754-2774
Mailing address:
  • Phone: 503-752-4459
  • Fax: 541-754-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRP0000145
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TRUSHAR PATEL
Title or Position: OWNER
Credential:
Phone: 503-752-4459