NPI 1215314034

Yakov Baghdanov

Practitioner Driver Beaverton, OR

Practice location

Address: 754 NW Fieldcrest Way APT Q307, Beaverton, OR 97006-7741
Phone: (503) 961-3056

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 5651047 (OR)

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Registry record

NPI: 1215314034
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Apr 2015
Record last updated: 30 Apr 2015

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.