Provider Demographics
NPI:1447512041
Name:YUAN, AMY (DO)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:YUAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 MINNEQUA AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-3734
Mailing Address - Country:US
Mailing Address - Phone:719-564-0660
Mailing Address - Fax:719-564-0037
Practice Address - Street 1:340 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1869
Practice Address - Country:US
Practice Address - Phone:541-526-6635
Practice Address - Fax:541-526-6636
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0057203207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology