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General NPI Number Information
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NPI Number | 1568993590
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Entity Type | Individual
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Provider Name | BENJAMIN R YU M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 4800 SAND POINT WAY NE MS OA.5.154
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City | SEATTLE
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State | WA
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Zip | 98105-3901
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Country | US
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Telephone | 206-987-3268
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Fax | 206-988-2246
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Provider Business Mailing Address
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Address Line | 5415 SW WESTGATE DR
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City | PORTLAND
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State | OR
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Zip | 97221-2409
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Country | US
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Telephone | 503-645-3581
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Fax | 917-420-0297
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD.61174247
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 63716
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD216912
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License Number State | OR
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