Yerby, Mark S.

Yerby, Mark S. is an sole proprietor health care provider with primary practice located at 830 Ne 47Th Ave , Portland OR 97213-2212. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Vascular Neurology. Other Service Providers / Specialist is his primary health care specialty. Yerby, Mark S. can be contacted via phone (503) 978-0178.

Contact Information

Primary practice address
830 Ne 47Th Ave Portland OR 97213-2212
Phone: (503) 978-0178
Fax: (503) 286-7939
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD10835 Oregon
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X MD10835 Oregon

Profile Details

NPI number 1891960860
LBN Legal business name Yerby, Mark S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 29th, 2008
Last updated Feb 29th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891960860 NPPES
Oregon MEDICAID 060160
Oregon Other 1170059
Oregon Other 0000BJBPV
Oregon Other 099529000
Oregon Other K72601
Oregon Other R0000BJBPV

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