Healthcare Provider Details

I. General information

NPI: 1477417293
Provider Name (Legal Business Name): DR. ALYAA YERHIAAHMED ABBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N EVERGREEN RD
WOODBURN OR
97071-3091
US

IV. Provider business mailing address

12345 SW CONESTOGA DR APT 57
BEAVERTON OR
97008-8367
US

V. Phone/Fax

Practice location:
  • Phone: 503-982-8198
  • Fax: 503-982-8269
Mailing address:
  • Phone: 413-210-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0020604
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: