NPI 1144012188

Samuel Sidbewindin Yameogo, DRIVER

Practitioner Driver Damascus, OR

Practice location

Address: 15576 SE Highway 224, Damascus, OR 97089-7812
Phone: (415) 871-5474

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence B257000 (OR)

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Registry record

NPI: 1144012188
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 May 2025
Record last updated: 17 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.