YC SBHC NPI 1801255328

NPI Information

NPI: 1801255328
Provider Name: YC SBHC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
120 LARCH PL
YAMHILL, OR
ZIP 97148
Phone: (503) 852-6960
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YC SBHC is a primary care nurse practitioner in Yamhill, OR. YC SBHC NPI is 1801255328. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

120 LARCH PL
YAMHILL, OR
ZIP 97148-007
Phone: (503) 852-6960

The provider's authorized official is Michael P Jaczko .
The authorized official title is Medical Director and has the following contact phone number (503) 852-6960.

The enumeration date for this NPI number is 2/11/2016 and was last updated on 2/11/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	201250196NP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1487647954	OTHER		NPI
2	500652931	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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