Provider Demographics
NPI:1003514514
Name:YAMAMORI, STEVEN DOUGLAS (QMHA-R)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:YAMAMORI
Suffix:
Gender:M
Credentials:QMHA-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 CHASA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1914
Mailing Address - Country:US
Mailing Address - Phone:602-369-3531
Mailing Address - Fax:
Practice Address - Street 1:1190 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4610
Practice Address - Country:US
Practice Address - Phone:602-369-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator