Provider Demographics
NPI:1740412394
Name:YAMASHITA, DON
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:YAMASHITA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4076 NEELY ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT WAINWIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-0000
Mailing Address - Country:US
Mailing Address - Phone:907-361-5765
Mailing Address - Fax:907-361-4838
Practice Address - Street 1:4076 NEELY ROAD
Practice Address - Street 2:
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-0000
Practice Address - Country:US
Practice Address - Phone:907-361-5765
Practice Address - Fax:907-361-4838
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033-0003509183500000X
NH3251183500000X
VT35091835P0018X
2865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital