Provider Information for 1356686398
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MARK ANDERSON YEUNG LCSW, MPH
Sex: Male
NPI: 1356686398
Last Updated: 2023-09-25
Certification Date: 2023-09-18
Certification Date: 2023-09-18
Details
| Name | Value | ||||||||||||||||
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| NPI | 1356686398 | ||||||||||||||||
| Enumeration Date | 2012-12-03 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1110 SE ALDER ST STE 301 PORTLAND, OR 97214-2400 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 1110 SE ALDER ST STE 301 PORTLAND, OR 97214-2400 United States Phone: 510-604-0263 | Fax: | ||||||||||||||||
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