Healthcare Provider Details

I. General information

NPI: 1750265237
Provider Name (Legal Business Name): DANIEL JUNHONG YANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24988 SE STARK ST STE 265
GRESHAM OR
97030-8322
US

IV. Provider business mailing address

11803 NE 124TH AVE APT 84
VANCOUVER WA
98682-2095
US

V. Phone/Fax

Practice location:
  • Phone: 503-674-1580
  • Fax:
Mailing address:
  • Phone: 217-778-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH-0020524
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH61563213
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: