Healthcare Provider Details

I. General information

NPI: 1639154339
Provider Name (Legal Business Name): JAMES M YASUI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7370 170TH AVE NE
REDMOND WA
98052-4457
US

IV. Provider business mailing address

7370 170TH AVE NE
REDMOND WA
98052-4457
US

V. Phone/Fax

Practice location:
  • Phone: 425-895-8242
  • Fax:
Mailing address:
  • Phone: 425-895-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00009645
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: