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NPI Code Detail

MEDICARE: DR. DANIELLE SUE SHANNON PHARMD, MSCR

MEDICARE: DR. DANIELLE SUE SHANNON PHARMD, MSCR
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
1183500000XPharmacistRP445136PA
2183500000XPharmacistRPH0013564OR
31835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH0013564OR

General Provider Information

NPI Number : 1902116148
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIELLE SUE SHANNON PHARMD, MSCR
Provider Business Mailing Address
First Line : 2995 RYAN DR SE
Second Line :
City : SALEM
State : OR
Zip : 97301-5157
Country : US
Telephone Number : 503-587-5103
Fax Number :
Provider Business Practice Location Address
First Line : 2995 RYAN DR SE
Second Line :
City : SALEM
State : OR
Zip : 97301-5157
Country : US
Telephone Number : 503-587-5103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2010
Last Update Date : 12/04/2018

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