MEDICARE: DR. YOHANNA SACHIKO VERNON M.D.

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
1	208000000X	Pediatrics Physician	5701	NE

General Provider Information

NPI Number	:	1396943494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOHANNA SACHIKO VERNON M.D.

Provider Business Mailing Address
First Line	:	1257 E 3000 N
Second Line	:
City	:	NORTH LOGAN
State	:	UT
Zip	:	84341-6802
Country	:	US
Telephone Number	:	435-799-7953
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 E 1400 N STE 118
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-2549
Country	:	US
Telephone Number	:	435-799-7953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	02/04/2025

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Directions to “ DR. YOHANNA SACHIKO VERNON M.D.” Practice Location

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