Provider Demographics
NPI:1689915118
Name:YUVASHEVA, EKATERINA (RPH)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:YUVASHEVA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 MARK AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1110
Mailing Address - Country:US
Mailing Address - Phone:224-595-0589
Mailing Address - Fax:
Practice Address - Street 1:30 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-1706
Practice Address - Country:US
Practice Address - Phone:907-374-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist