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NPI Code Detail

MEDICARE: MARK YAZHARI

MEDICARE: MARK YAZHARI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1275472490
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK YAZHARI
Provider Business Mailing Address
First Line : 2 INDEPENDENCE AVE
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-1401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 930 CHESTNUT RIDGE RD
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-2807
Country : US
Telephone Number : 304-293-5323
Fax Number : 304-293-8724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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