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General NPI Number Information
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NPI Number | 1144182098
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Entity Type | Individual
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Provider Name | DEANA YAKYMCHUK
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 5039 SE BRIAR CT
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City | PORTLAND
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State | OR
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Zip | 97267-5974
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Country | US
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Telephone | 360-325-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 5039 SE BRIAR CT
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City | PORTLAND
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State | OR
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Zip | 97267-5974
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State | OR
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Taxonomy #7
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | OR
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