Individual
SAMUEL SIDBEWINDIN YAMEOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DRIVER
Contact information
Practice address
15576 SE HIGHWAY 224, DAMASCUS, OR 97089-7812
(415) 871-5474
Mailing address
15576 SE HIGHWAY 224, DAMASCUS, OR 97089-7812
(415) 871-5474
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B257000
OR
Other
Enumeration date
05/17/2025
Last updated
05/17/2025
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