Individual provider Active NPI

Diane Wong Yamamoto, PHARM.D.

  • Pharmacist
  • Bend, OR
National Provider Identifier
1386909182
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH10390 Issued in OR
Practice address
740 NE 3Rd St, Ste 3 PMB 120
Bend, OR 97701-4700
Phone
(818) 237-0038
Fax
(541) 317-3404
NPI assigned
Jul 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH39920 CA
Pharmacist 183500000X 09119 NV
Pharmacist 183500000X RPH10390 OR Primary

Addresses

Primary practice location

740 NE 3Rd St, Ste 3 PMB 120
Bend, OR 97701-4700

Mailing address

740 NE 3Rd St, Ste 3 PMB 120
Bend, OR 97701-4700
Phone (818) 237-0038

Other names 1

  • Diane Wong Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH39920CAMDPharmacist
09119NVMDPharmacist
RPH10390ORMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1386909182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 NE 3RD ST, STE 3 PMB 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014700",
            "telephone_number": "818-237-0038",
            "fax_number": "541-317-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 NE 3RD ST, STE 3 PMB 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014700",
            "telephone_number": "818-237-0038",
            "fax_number": "541-317-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "DIANE",
        "middle_name": "WONG",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-08",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH39920",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "09119",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH10390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "WONG",
            "credential": "PHARM.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.