Provider Demographics
NPI:1033282595
Name:BOEVE, SHANDRA NOELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANDRA
Middle Name:NOELLE
Last Name:BOEVE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-8290
Mailing Address - Country:US
Mailing Address - Phone:425-922-2459
Mailing Address - Fax:
Practice Address - Street 1:17254 140TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-7014
Practice Address - Country:US
Practice Address - Phone:425-226-7000
Practice Address - Fax:425-235-8796
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00064004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist