Provider Demographics
NPI:1699723304
Name:YANKEE, JOSEPH E (DO)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:YANKEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6564 SE LAKE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2238
Mailing Address - Country:US
Mailing Address - Phone:503-652-1456
Mailing Address - Fax:503-652-1451
Practice Address - Street 1:6564 SE LAKE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2238
Practice Address - Country:US
Practice Address - Phone:503-652-1456
Practice Address - Fax:503-652-1456
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORDO19458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150872Medicaid
ORG64642Medicare UPIN
OR132814Medicare PIN