Healthcare Provider Details

I. General information

NPI: 1306296066
Provider Name (Legal Business Name): JAMES JAE-HYUNG YOO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19260 SW 65TH AVE MEDICAL PLAZA OFFICE BUILDING 2 SUITE 435
TUALATIN OR
97062
US

IV. Provider business mailing address

19260 SW 65TH AVE MEDICAL PLAZA OFFICE BUILDING 2 SUITE 435
TUALATIN OR
97062
US

V. Phone/Fax

Practice location:
  • Phone: 971-262-9700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD211737
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: