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Individual

THOMAS HAROLD YACOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900
Mailing address
1522 NE 56TH AVE, PORTLAND, OR 97213-3654
(650) 228-4790

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA228914
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
10/14/2024
Last updated
03/19/2026
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