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General NPI Number Information
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NPI Number | 1366700627
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Entity Type | Individual
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Provider Name | MICHELLE YANG
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Gender | Female
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 11790 SW BARNES RD STE 280
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City | PORTLAND
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State | OR
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Zip | 97225-5935
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Country | US
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Telephone | 503-626-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 3027 SE 28TH AVE
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City | PORTLAND
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State | OR
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Zip | 97202-2002
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Country | US
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Telephone | 541-580-9541
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | D10967
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License Number State | OR
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