Individual provider Active NPI

Susan Marie Yazvac, DC, DACBR

  • Radiology Chiropractor
  • Portland, OR
National Provider Identifier
1679529200
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
2014 Issued in OR
Practice address
4010 SE 42ND Ave
Portland, OR 97206-3211
Phone
(503) 771-8105
Fax
(503) 777-5683
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X 2014 OR Primary

Addresses

Primary practice location

4010 SE 42ND Ave
Portland, OR 97206-3211

Mailing address

4010 SE 42ND Ave
Portland, OR 97206-3211
Phone (503) 771-8105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2014ORMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates Northwest LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679529200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 SE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063211",
            "telephone_number": "503-771-8105",
            "fax_number": "503-777-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 SE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063211",
            "telephone_number": "503-771-8105",
            "fax_number": "503-777-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZVAC",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC, DACBR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "OR",
            "license": "2014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.