Individual
YANINA M BENIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19185 SW 90TH AVE, TUALATIN, OR 97062-7558
(503) 813-0377
Mailing address
19185 SW 90TH AVE, TUALATIN, OR 97062-7558
(503) 813-0377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00037323
WA
207Q00000X
Family Medicine Physician
Primary
MD21765
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133937
—
OR
05
—
8508681
—
WA
Enumeration date
05/25/2006
Last updated
02/04/2022
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