Healthcare Provider Details

I. General information

NPI: 1124126362
Provider Name (Legal Business Name): YOLANDA BEATRIZ SUAREZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YOLANDA ENGLISH

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8562
  • Fax: 503-418-5505
Mailing address:
  • Phone: 503-494-8562
  • Fax: 503-418-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberDO28670
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberDO2242
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberDO28670
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO28670
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: