Provider Demographics
NPI:1316201114
Name:ZAHLER, SHANNON KATY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:KATY
Last Name:ZAHLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22075 NW IMBRIE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7578
Mailing Address - Country:US
Mailing Address - Phone:503-747-1133
Mailing Address - Fax:503-747-1127
Practice Address - Street 1:22075 NW IMBRIE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7578
Practice Address - Country:US
Practice Address - Phone:503-747-1133
Practice Address - Fax:503-747-1127
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8838183500000X
ORRPH-00088381835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist