Provider Demographics
NPI:1508858812
Name:YILDIRIM, ZAFER (MD,PHD)
Entity Type:Individual
Prefix:
First Name:ZAFER
Middle Name:
Last Name:YILDIRIM
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-7154
Mailing Address - Country:US
Mailing Address - Phone:360-414-2048
Mailing Address - Fax:360-575-6749
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2310
Practice Address - Country:US
Practice Address - Phone:360-414-7878
Practice Address - Fax:360-414-7876
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043047207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Not Answered207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8386294Medicaid
WA8930190OtherCRIME VICTIMS
P00154540OtherRR MEDICARE
OR029007Medicaid
WA221981OtherLABOR & IND.
OR029007Medicaid
WA8386294Medicaid