Provider Demographics
NPI:1881631745
Name:YUH, GRACE E (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:E
Last Name:YUH
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:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97308-0391
Mailing Address - Country:US
Mailing Address - Phone:503-814-1398
Mailing Address - Fax:503-814-1402
Practice Address - Street 1:2700 SE STRATUS AVE STE A
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6258
Practice Address - Country:US
Practice Address - Phone:503-435-6593
Practice Address - Fax:503-435-4543
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHD1496812085R0001X
ORMD1836252085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500725395Medicaid
ORR194310OtherMEDICARE PTAN OREGON
CA00A786740Medicaid
CAA78674OtherMEDICAL LICENSE
ORMD183625OtherMEDICAL LICENSE OREGON
BY7781342OtherDEA
BY7781342OtherDEA