Individual
MS. STEPHANIE KELLY YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 NE MLK BLVD, PORTLAND, OR 97232-2941
(503) 232-1099
Mailing address
30 NE MLK BLVD, PORTLAND, OR 97232-2941
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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