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NPI Code Detail

MEDICARE: JANELLE DEANNE YUTZIE MD

MEDICARE:   JANELLE DEANNE YUTZIE  MD
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
1208600000XSurgery Physician5936KS
2208600000XSurgery PhysicianMD157696OR

General Provider Information

NPI Number : 1720200025
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE DEANNE YUTZIE MD
Provider Business Mailing Address
First Line : PO BOX 3158
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3158
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1003 PROVIDENCE DR
Second Line : STE 210
City : NEWBERG
State : OR
Zip : 97132-7523
Country : US
Telephone Number : 503-537-5620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 11/30/2021

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Directions to “ JANELLE DEANNE YUTZIE MD” Practice Location

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