Healthcare Provider Details

I. General information

NPI: 1295919603
Provider Name (Legal Business Name): JOSEPH E. YANKEE DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6564 SE LAKE ROAD SUITE 100
MILWAUKIE OR
97222-2238
US

IV. Provider business mailing address

6564 SE LAKE ROAD SUITE 100
MILWAUKIE OR
97222-2238
US

V. Phone/Fax

Practice location:
  • Phone: 503-652-1456
  • Fax: 503-652-1451
Mailing address:
  • Phone: 503-652-1456
  • Fax: 503-652-1451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberDO19458
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO19458
License Number StateOR

VIII. Authorized Official

Name: MS. JOSEPH EARL YANKEE
Title or Position: OWNER/DOCTOR
Credential: DO
Phone: 503-652-1456