Provider Demographics
NPI:1124126362
Name:SUAREZ, YOLANDA BEATRIZ (DO)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:BEATRIZ
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:ENGLISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-8562
Mailing Address - Fax:503-418-5505
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-8562
Practice Address - Fax:503-418-5505
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO28670207QG0300X, 207QH0002X, 207Q00000X
NVDO2242207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR271310Medicaid
16383948OtherCAQH
ORR143462Medicare PIN