Yocky, Clarence Wayne
Yocky, Clarence Wayne is an individual health care provider with primary practice located at 9670 Sw Beaverton Hillsdale Hwy , Beaverton OR 97005-3307. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Yocky, Clarence Wayne can be contacted via phone (503) 626-9494.Contact Information
Primary practice address
9670 Sw Beaverton Hillsdale Hwy
Beaverton OR 97005-3307
Phone: (503) 626-9494
Fax: (503) 646-8401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0861 | Oregon |
Profile Details
| NPI number | 1629167218 |
|---|---|
| LBN Legal business name | Yocky, Clarence Wayne |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629167218 | NPPES |
| Oregon | MEDICAID | 076732 |
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