Healthcare Provider Details

I. General information

NPI: 1336843879
Provider Name (Legal Business Name): IRENE YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NE MOTHER JOSEPH PL
VANCOUVER WA
98664-3200
US

IV. Provider business mailing address

400 NE MOTHER JOSEPH PL
VANCOUVER WA
98664-3200
US

V. Phone/Fax

Practice location:
  • Phone: 360-514-2142
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.OP.70117206
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: