Provider Demographics
NPI:1255588661
Name:YANG, IRENE H (RPH)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:H
Last Name:YANG
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 1:1330 ROCKEFELLER AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1684
Mailing Address - Country:US
Mailing Address - Phone:425-261-4940
Mailing Address - Fax:425-225-1000
Practice Address - Street 1:1330 ROCKEFELLER AVE STE 210
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1676
Practice Address - Country:US
Practice Address - Phone:425-261-4940
Practice Address - Fax:206-248-4627
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00016659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist