Provider Demographics
NPI:1285893958
Name:LITTLE, YANA K (MD)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:K
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9323 NW OLD SKYLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97231-2600
Mailing Address - Country:US
Mailing Address - Phone:207-317-7414
Mailing Address - Fax:
Practice Address - Street 1:8329 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:BUILDING 2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2215
Practice Address - Country:US
Practice Address - Phone:503-413-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD162430207Q00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002338601Medicare PIN