Provider Demographics
NPI:1164070595
Name:MYETTE, YVONNE M (RN)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:M
Last Name:MYETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:M
Other - Last Name:LEVERNOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14834 NW ORCHID ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6941
Mailing Address - Country:US
Mailing Address - Phone:503-729-4281
Mailing Address - Fax:
Practice Address - Street 1:14834 NW ORCHID ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-6941
Practice Address - Country:US
Practice Address - Phone:503-729-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR086006468RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health