Provider Demographics
NPI:1891341541
Name:HAN, YIDING (LMFT)
Entity Type:Individual
Prefix:
First Name:YIDING
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:MAY
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:4804 NW BETHANY BLVD STE I2
Mailing Address - Street 2:424
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-9195
Mailing Address - Country:US
Mailing Address - Phone:503-850-8484
Mailing Address - Fax:
Practice Address - Street 1:167 NE 79TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6877
Practice Address - Country:US
Practice Address - Phone:503-850-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61123449106H00000X
IL166001352106H00000X
ORT-1893106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist