Provider Demographics
NPI:1033712625
Name:BARAK, YOUVAL (DC)
Entity Type:Individual
Prefix:DR
First Name:YOUVAL
Middle Name:
Last Name:BARAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NE 146TH AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-4273
Mailing Address - Country:US
Mailing Address - Phone:180-874-7098
Mailing Address - Fax:
Practice Address - Street 1:13150 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-2350
Practice Address - Country:US
Practice Address - Phone:503-252-5911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor