Provider Demographics
NPI:1528076627
Name:BURAKA, YONAS NEMERA (QMHP)
Entity type:Individual
Prefix:
First Name:YONAS
Middle Name:NEMERA
Last Name:BURAKA
Suffix:
Gender:M
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 NE 15TH AVE
Mailing Address - Street 2:APT # 3
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-9034
Mailing Address - Country:US
Mailing Address - Phone:206-331-5989
Mailing Address - Fax:
Practice Address - Street 1:5432 N ALBINA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-2304
Practice Address - Country:US
Practice Address - Phone:503-283-3763
Practice Address - Fax:503-735-0912
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health