Healthcare Provider Details

I. General information

NPI: 1720752637
Provider Name (Legal Business Name): MATTHEW R YEATES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NEWTON RD
IOWA CITY IA
52242
US

IV. Provider business mailing address

274 EVERSULL LN
IOWA CITY IA
52245-9372
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-8674
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0018515
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61187336
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: