Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | DP00171 | OR |
Y | 222Z00000X | Podiatrist | DP00171 | OR |
N | 213ES0131X | Foot Surgery | DP00171 | OR |
NPI | 1366400517 |
---|---|
Provider Name | Dr. Mark L Yeske |
First Address | Pendleton, OR 97801-3463 |
Second Address | Pendleton, OR 97801-2039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 24/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
162099 | (05) | OR |
480033064 | RAILROAD MEDICARE (01) | OR |
48431001 | BLUE CROSS OF OREGON (01) | OR |
T68292 | (02) | OR |