Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | LL18901 | OR |
Y | 207Q00000X | Family Doctor | MD153986 | OR |
NPI | 1225260946 |
---|---|
Provider Name | Qiang Yin |
First Address | Klamath Falls, OR 97603-4746 |
Second Address | Chiloquin, OR 97624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2009 |
Last Update Date | 04/09/2019 |