Healthcare Provider Details

I. General information

NPI: 1578252342
Provider Name (Legal Business Name): MINDFUL MEDS DR. KARA SHIRLEY PHARMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE STE 8238
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

1250 N WENATCHEE AVE SUITE H PMB 352
WENATCHEE WA
98801
US

V. Phone/Fax

Practice location:
  • Phone: 509-593-8728
  • Fax: 509-470-8562
Mailing address:
  • Phone: 509-593-8728
  • Fax: 509-470-8562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. KERRIE LEE SHIRLEY
Title or Position: CONSULTANT & OWNER
Credential: PHARMD, BCPS, BCPP
Phone: 509-593-8728