Provider Demographics
NPI:1013077379
Name:YAMASHITA, BETTY H (RPH)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:H
Last Name:YAMASHITA
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 1:975 CHAMBERS ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4591
Mailing Address - Country:US
Mailing Address - Phone:801-479-7466
Mailing Address - Fax:801-387-6325
Practice Address - Street 1:975 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4591
Practice Address - Country:US
Practice Address - Phone:801-387-6300
Practice Address - Fax:801-387-6325
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT143088-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist