MEDICARE: DR. KERRIE LEE SHIRLEY PHARMD, BCPS, BCPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP-044967L	PA
2	183500000X	Pharmacist	RPH014459	OR
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RP044967L	PA
4	1835G0303X	Geriatric Pharmacist	RP044967L	PA
5	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PH60980446	WA
6	1835P1300X	Psychiatric Pharmacist	RP044967L	PA
7	1835P1300X	Psychiatric Pharmacist	RPH014459	OR
8	1835P2201X	Ambulatory Care Pharmacist	RPH014459	OR
9	1835P2201X	Ambulatory Care Pharmacist	PH60980446	WA
10	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH014459	OR
11	1835P1200X	Pharmacotherapy Pharmacist	RP044967L	PA
12	1835P1200X	Pharmacotherapy Pharmacist	RPH014459	OR
13	1835P1200X	Pharmacotherapy Pharmacist	PH60980446	WA
14	1835P1300X	Psychiatric Pharmacist	PH60980446	WA

General Provider Information

NPI Number	:	1942206313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRIE LEE SHIRLEY PHARMD, BCPS, BCPP

Provider Business Mailing Address
First Line	:	1250 N WENATCHEE AVE SUITE H PMB 352
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801
Country	:	US
Telephone Number	:	509-593-8728
Fax Number	:	509-470-8562

Provider Business Practice Location Address
First Line	:	522 W RIVERSIDE AVE STE 8238
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-0580
Country	:	US
Telephone Number	:	509-593-8728
Fax Number	:	509-470-8562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	05/05/2023

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