Provider Demographics
NPI:1992254080
Name:AMARAL, YADIRA
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:AMARAL
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 1:1698 E MCANDREWS RD
Mailing Address - Street 2:STE 170
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5589
Mailing Address - Country:US
Mailing Address - Phone:541-732-6955
Mailing Address - Fax:541-732-6955
Practice Address - Street 1:1698 E MCANDREWS RD
Practice Address - Street 2:STE 170
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5589
Practice Address - Country:US
Practice Address - Phone:541-732-6955
Practice Address - Fax:541-732-6955
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker