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NPI Code Detail

MEDICARE: MRS. SHANNON L HOLDEN PHARMD, RPH

MEDICARE: MRS. SHANNON L HOLDEN PHARMD, RPH
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
1183500000XPharmacistPH00039003WA

General Provider Information

NPI Number : 1932199726
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANNON L HOLDEN PHARMD, RPH
Provider Business Mailing Address
First Line : 2310 W ASHLEY AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99208-9284
Country : US
Telephone Number : 509-467-1682
Fax Number :
Provider Business Practice Location Address
First Line : 6002 N LIDGERWOOD ST
Second Line :
City : SPOKANE
State : WA
Zip : 99208-1124
Country : US
Telephone Number : 509-241-2770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 08/10/2007

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