Provider Demographics
NPI:1225185671
Name:YAO, YVONNE A (MD)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:A
Last Name:YAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EAST MAIN ST #360
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002
Mailing Address - Country:US
Mailing Address - Phone:253-545-5800
Mailing Address - Fax:
Practice Address - Street 1:1 EAST MAIN ST #360
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002
Practice Address - Country:US
Practice Address - Phone:253-545-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-102400207V00000X
WAMD60506634207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102400 1Medicaid
IL962341Medicare PIN
IL036102400 1Medicaid
IL962341Medicare PIN