Provider Demographics
NPI:1942326038
Name:YOMAN, JEROME (PHD, ABBP)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:
Last Name:YOMAN
Suffix:
Gender:M
Credentials:PHD, ABBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2373 NW 185TH AVENUE
Mailing Address - Street 2:#644
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7076
Mailing Address - Country:US
Mailing Address - Phone:503-488-0889
Mailing Address - Fax:971-329-4770
Practice Address - Street 1:2373 NW 185TH AVENUE
Practice Address - Street 2:#644
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7076
Practice Address - Country:US
Practice Address - Phone:503-488-0889
Practice Address - Fax:971-329-4770
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13841103TC0700X
OR1894103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP13841Medicare ID - Type Unspecified