MEDICARE: DR. VEE S YOONG PA-C, PH.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	363A00000X	Physician Assistant	630	AK
2	363AM0700X	Medical Physician Assistant	258	HI
3	363AM0700X	Medical Physician Assistant	10003812	WA
4	363AM0700X	Medical Physician Assistant	169107	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700833217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VEE S YOONG PA-C, PH.D.

Provider Business Mailing Address
First Line	:	18 NW 20TH AVE
Second Line	:
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-4175
Country	:	US
Telephone Number	:	360-952-4457
Fax Number	:	360-828-7409

Provider Business Practice Location Address
First Line	:	135 NE 102ND AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220-4167
Country	:	US
Telephone Number	:	503-894-9005
Fax Number	:	503-719-4178

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	12/03/2021

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