Healthcare Provider Details

I. General information

NPI: 1376748459
Provider Name (Legal Business Name): ESTHER LOK-YAN YUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 N GANTENBEIN AVE
PORTLAND OR
97227-1623
US

IV. Provider business mailing address

101 SW MAIN ST STE 940
PORTLAND OR
97204-3216
US

V. Phone/Fax

Practice location:
  • Phone: 503-276-6500
  • Fax:
Mailing address:
  • Phone: 503-464-9034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT190142
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD439676
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD154709
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberMD154709
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: