Provider Demographics
NPI:1619068442
Name:YU, MICHAEL MON FAI (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MON FAI
Last Name:YU
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 1:12770 SE STARK ST
Mailing Address - Street 2:PLAZA 125, BUILDING C
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-1539
Mailing Address - Country:US
Mailing Address - Phone:503-659-2844
Mailing Address - Fax:503-525-5875
Practice Address - Street 1:12770 SE STARK ST
Practice Address - Street 2:PLAZA 125, BUILDING C
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1539
Practice Address - Country:US
Practice Address - Phone:503-659-2844
Practice Address - Fax:503-525-5875
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273125111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor