Provider Demographics
NPI:1487850194
Name:BENEFIELD, RUSSELL JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:JAMES
Last Name:BENEFIELD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PLUM LN APT 3
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-5012
Mailing Address - Country:US
Mailing Address - Phone:360-540-0300
Mailing Address - Fax:
Practice Address - Street 1:1206 N 40TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-9456
Practice Address - Country:US
Practice Address - Phone:509-576-6833
Practice Address - Fax:509-576-6827
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00069831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist