MEDICARE: MRS. ANDREA SHANNON WHISTON 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
1	183500000X	Pharmacist	00021916	WA

General Provider Information

NPI Number	:	1316459985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA SHANNON WHISTON PHARMD

Provider Business Mailing Address
First Line	:	8108 SPIEDEN DR
Second Line	:
City	:	PASCO
State	:	WA
Zip	:	99301-7913
Country	:	US
Telephone Number	:	509-863-5604
Fax Number	:

Provider Business Practice Location Address
First Line	:	1906 GEORGE WASHINGTON WAY
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99354-2308
Country	:	US
Telephone Number	:	509-943-9173
Fax Number	:

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

Provider Enumeration Date	:	11/03/2017
Last Update Date	:	11/03/2017

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