Provider Demographics
NPI:1275808677
Name:PANTHER, SHANNON G (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:G
Last Name:PANTHER
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 1:5615 W SUNSET HWY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-9454
Mailing Address - Country:US
Mailing Address - Phone:509-838-9100
Mailing Address - Fax:
Practice Address - Street 1:5615 W SUNSET HWY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-9454
Practice Address - Country:US
Practice Address - Phone:509-838-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00060210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist