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NPI Code Detail

MEDICARE: JOHN YONGE III M.D.

MEDICARE: JOHN YONGE III 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
1208600000XSurgery PhysicianMD61066252WA
2390200000XStudent in an Organized Health Care Education/Training Program
3208600000XSurgery PhysicianMD214731OR

General Provider Information

NPI Number : 1841636941
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN YONGE III M.D.
Provider Business Mailing Address
First Line : 10000 SE MAIN ST STE 316
Second Line :
City : PORTLAND
State : OR
Zip : 97216-2470
Country : US
Telephone Number : 503-256-1575
Fax Number :
Provider Business Practice Location Address
First Line : 10000 SE MAIN ST STE 316
Second Line :
City : PORTLAND
State : OR
Zip : 97216-2470
Country : US
Telephone Number : 503-256-1575
Fax Number : 503-253-9848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2013
Last Update Date : 09/23/2024

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