Healthcare Provider Details

I. General information

NPI: 1144312166
Provider Name (Legal Business Name): JOHN P YANG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 05/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 WELCH ST
SILVERTON OR
97381
US

IV. Provider business mailing address

PO BOX 278
WOODBURN OR
97071-0278
US

V. Phone/Fax

Practice location:
  • Phone: 503-873-8853
  • Fax: 503-873-8355
Mailing address:
  • Phone: 971-983-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA96748
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD171415
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: