Provider Demographics
NPI:1497825848
Name:YEWCHUK, JAMES M (DC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:YEWCHUK
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 1:3150 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4612
Mailing Address - Country:US
Mailing Address - Phone:541-273-5433
Mailing Address - Fax:541-850-2461
Practice Address - Street 1:3150 S 6TH ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4612
Practice Address - Country:US
Practice Address - Phone:541-273-5433
Practice Address - Fax:541-850-2461
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0600001797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR133063Medicare ID - Type UnspecifiedGROUP #
ORU80536Medicare UPIN