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NPI Code Detail

MEDICARE: MRS. ALICE RACHEL YOUNG PA

MEDICARE: MRS. ALICE RACHEL YOUNG PA
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
1363A00000XPhysician AssistantPA152139OR
2363AM0700XMedical Physician AssistantPA152139OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3R0000WFBTVOTHERORNBMC GROUP MEDICARE NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
193-0635514OTHERORNBMC GROUP TAX ID FOR BILLING
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41407812365OTHERORNBMC GROUP NPI
5PA152139OTHERORSTATE OF OREGON

General Provider Information

NPI Number : 1831410455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALICE RACHEL YOUNG PA
Provider Business Mailing Address
First Line : 1900 WOODLAND DR
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2045
Country : US
Telephone Number : 541-267-1515
Fax Number : 541-266-4501
Provider Business Practice Location Address
First Line : 1900 WOODLAND DR
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2045
Country : US
Telephone Number : 541-267-1515
Fax Number : 541-266-4501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2010
Last Update Date : 03/19/2026

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1942274956 — DR. CHARLES W JAMES M.D.
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Directions to “ MRS. ALICE RACHEL YOUNG PA” Practice Location

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