Provider Demographics
NPI:1710084611
Name:RUSS, YUN H (RPH BCPP)
Entity Type:Individual
Prefix:
First Name:YUN
Middle Name:H
Last Name:RUSS
Suffix:
Gender:F
Credentials:RPH BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6617 SE COUGAR MOUNTAIN WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5608
Mailing Address - Country:US
Mailing Address - Phone:206-762-1010
Mailing Address - Fax:206-764-2572
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:VAPSHCS S-116-MHC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-277-4500
Practice Address - Fax:206-764-2572
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000167991835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric