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NPI Code Detail

MEDICARE: SHANNON G DIBARTOLO PHARMD

MEDICARE: SHANNON G DIBARTOLO PHARMD
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
1183500000XPharmacistPH00060210WA

General Provider Information

NPI Number : 1275808677
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON G DIBARTOLO PHARMD
Provider Business Mailing Address
First Line : 5601 E SPRAGUE AVE
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99212-0826
Country : US
Telephone Number : 509-842-0003
Fax Number :
Provider Business Practice Location Address
First Line : 5601 E SPRAGUE AVE
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99212-0826
Country : US
Telephone Number : 509-842-0003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2012
Last Update Date : 01/06/2025

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Directions to “ SHANNON G DIBARTOLO PHARMD” Practice Location

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