Provider Demographics
NPI:1205162799
Name:YERBO, JOEL K (APRNCNP)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:K
Last Name:YERBO
Suffix:
Gender:M
Credentials:APRNCNP
Other - Prefix:
Other - First Name:EYUAL
Other - Middle Name:K
Other - Last Name:YERBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6800 SW 105TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5487
Mailing Address - Country:US
Mailing Address - Phone:035-430-1777
Mailing Address - Fax:
Practice Address - Street 1:6800 SW 105TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-5487
Practice Address - Country:US
Practice Address - Phone:035-430-1777
Practice Address - Fax:503-372-5119
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 353548163W00000X
OHAPRNCNP021726363L00000X
OR10025183363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse