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General NPI Number Information
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NPI Number | 1386909182
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Entity Type | Individual
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Provider Name | DIANE WONG YAMAMOTO PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2012
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 740 NE 3RD ST, STE 3 PMB 120
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City | BEND
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State | OR
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Zip | 97701-4700
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Country | US
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Telephone | 818-237-0038
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Fax | 541-317-3404
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Provider Business Mailing Address
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Address Line | 740 NE 3RD ST, STE 3 PMB 120
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City | BEND
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State | OR
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Zip | 97701-4700
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Country | US
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Telephone | 818-237-0038
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Fax | 541-317-3404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH39920
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 09119
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH10390
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License Number State | OR
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