Provider Demographics
NPI:1124803218
Name:SLAPPER, YUKI PAGAN
Entity type:Individual
Prefix:
First Name:YUKI
Middle Name:PAGAN
Last Name:SLAPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 SE MCLOUGHLIN BLVD APT 208
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7783
Mailing Address - Country:US
Mailing Address - Phone:985-503-1982
Mailing Address - Fax:
Practice Address - Street 1:12730 SE MCLOUGHLIN BLVD APT 208
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7783
Practice Address - Country:US
Practice Address - Phone:985-503-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR106S00000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician