Provider Demographics
NPI:1962379180
Name:YELLOWHAIR, ADRIAN (CCHT)
Entity type:Individual
Prefix:MS
First Name:ADRIAN
Middle Name:
Last Name:YELLOWHAIR
Suffix:
Gender:M
Credentials:CCHT
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:YELLOWHAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCHT
Mailing Address - Street 1:5115 N DYSART RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-3032
Mailing Address - Country:US
Mailing Address - Phone:844-520-7412
Mailing Address - Fax:
Practice Address - Street 1:5115 N DYSART RD
Practice Address - Street 2:202-445
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-3032
Practice Address - Country:US
Practice Address - Phone:844-520-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2472R0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal Dialysis