Healthcare Provider Details

I. General information

NPI: 1316201114
Provider Name (Legal Business Name): SHANNON KATY ZAHLER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22075 NW IMBRIE DR
HILLSBORO OR
97124-7578
US

IV. Provider business mailing address

22075 NW IMBRIE DR
HILLSBORO OR
97124-7578
US

V. Phone/Fax

Practice location:
  • Phone: 503-747-1133
  • Fax: 503-747-1127
Mailing address:
  • Phone: 503-747-1133
  • Fax: 503-747-1127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8838
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0008838
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: