Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | H63159 | OR |
NPI | 1063448553 |
---|---|
Provider Name | Deborah D Huebbe Youhn |
First Address | Portland, OR 97213-0994 |
Second Address | Portland, OR 97213-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 04/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H63159 | (02) | |
P00281973 | RR MEDICARE (01) | OR |