Provider Demographics
NPI:1366785313
Name:YONKER, KATIE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:ELIZABETH
Last Name:YONKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 OAK ST SE STE 4060
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3990
Mailing Address - Country:US
Mailing Address - Phone:503-561-7000
Mailing Address - Fax:
Practice Address - Street 1:875 OAK ST SE STE 4060
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3990
Practice Address - Country:US
Practice Address - Phone:503-561-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD197779208200000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery