Individual
STACY A YAMASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
545 NE 47TH AVE, SUITE 215, PORTLAND, OR 97213-2238
(503) 731-2990
Mailing address
545 NE 47TH AVE, SUITE 215, PORTLAND, OR 97213-2238
(503) 731-2990
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD15786
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288474
—
OR
05
—
8206039
—
WA
01
—
P00058329
RR MC
OR
Enumeration date
12/23/2005
Last updated
10/15/2007
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