Provider Demographics
NPI:1356504989
Name:YAMASHITA, EMILY (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:YAMASHITA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:SHEREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:600 NE 8TH ST STE 300
Mailing Address - Street 2:ATTN: CREDENTIALING DEPARTMENT
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7318
Mailing Address - Country:US
Mailing Address - Phone:503-988-5155
Mailing Address - Fax:503-988-3015
Practice Address - Street 1:421 SW OAK ST
Practice Address - Street 2:210
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1817
Practice Address - Country:US
Practice Address - Phone:503-988-7468
Practice Address - Fax:503-988-3015
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200950133NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR22959Medicaid
CT004236346Medicaid
ORR0000WCJHTMedicare Oscar/Certification
CTD400001183Medicare PIN