Provider Demographics
NPI:1528652542
Name:WALNECK, DIANA HWAYOUNG YOON (PHARMD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:HWAYOUNG YOON
Last Name:WALNECK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17922 N 65TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-6721
Mailing Address - Country:US
Mailing Address - Phone:520-307-2253
Mailing Address - Fax:
Practice Address - Street 1:1916 S LINDSAY RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7108
Practice Address - Country:US
Practice Address - Phone:480-892-6085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist