Healthcare Provider Details

I. General information

NPI: 1033213319
Provider Name (Legal Business Name): SHELBY BOTTEMILLER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 NE 145TH ST
SEATTLE WA
98155-7205
US

IV. Provider business mailing address

1531 NE 145TH ST
SEATTLE WA
98155-7205
US

V. Phone/Fax

Practice location:
  • Phone: 206-366-4672
  • Fax: 206-366-4674
Mailing address:
  • Phone: 206-366-4672
  • Fax: 206-366-4674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00060167
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH00060167
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: