Provider Demographics
NPI:1306940531
Name:CHEN, CHER YAO (MD)
Entity type:Individual
Prefix:
First Name:CHER YAO
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHER YAO
Other - Middle Name:
Other - Last Name:CHEN CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11420 SW SHROPE CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-4071
Mailing Address - Country:US
Mailing Address - Phone:703-785-3440
Mailing Address - Fax:
Practice Address - Street 1:2605 STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97310-5908
Practice Address - Country:US
Practice Address - Phone:971-301-3517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD258422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
T42472Medicare UPIN
132637Medicare ID - Type Unspecified