Provider Demographics
NPI:1982664637
Name:LIANG, YALE (MD)
Entity Type:Individual
Prefix:
First Name:YALE
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
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 92900
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97292-0900
Mailing Address - Country:US
Mailing Address - Phone:503-665-8176
Mailing Address - Fax:503-665-8178
Practice Address - Street 1:831 NW COUNCIL DR STE 101
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3722
Practice Address - Country:US
Practice Address - Phone:503-665-8176
Practice Address - Fax:503-665-8178
Is Sole Proprietor?:No
Enumeration Date:2006-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39823207Q00000X
ORMD27884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN280713100Medicaid
G52981Medicare UPIN