Provider Demographics
NPI:1144049115
Name:YASIN, MOSES SAMI (DC)
Entity type:Individual
Prefix:
First Name:MOSES
Middle Name:SAMI
Last Name:YASIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-1704
Mailing Address - Country:US
Mailing Address - Phone:541-900-5400
Mailing Address - Fax:
Practice Address - Street 1:100 E 2ND ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-1704
Practice Address - Country:US
Practice Address - Phone:541-900-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor