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Individual

YAKOV BAGHDANOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
754 NW FIELDCREST WAY APT Q307, BEAVERTON, OR 97006-7741
(503) 961-3056
Mailing address
754 NW FIELDCREST WAY APT Q307, BEAVERTON, OR 97006-7741
(503) 961-3056

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
5651047
OR

Other

Enumeration date
04/30/2015
Last updated
04/30/2015
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