Provider Demographics
NPI:1740576750
Name:YEE, JASON SEAN (RPH)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:SEAN
Last Name:YEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 S DECATUR BLVD
Mailing Address - Street 2:T0263
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2936
Mailing Address - Country:US
Mailing Address - Phone:702-878-0400
Mailing Address - Fax:702-878-0400
Practice Address - Street 1:278 S DECATUR BLVD
Practice Address - Street 2:T0263
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-2936
Practice Address - Country:US
Practice Address - Phone:702-878-0400
Practice Address - Fax:702-878-0400
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist