Healthcare Provider Details

I. General information

NPI: 1598497331
Provider Name (Legal Business Name): YEKASON YEANS PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3227 NORTHWEST AVE
BELLINGHAM WA
98225-1317
US

IV. Provider business mailing address

3227 NORTHWEST AVE
BELLINGHAM WA
98225-1317
US

V. Phone/Fax

Practice location:
  • Phone: 360-647-2175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61206318
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: