Provider Demographics
NPI:1326473422
Name:BEAMAN, SHANNON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:BEAMAN
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 1:9150 SW PIONEER CT
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9623
Mailing Address - Country:US
Mailing Address - Phone:503-515-6312
Mailing Address - Fax:
Practice Address - Street 1:9150 SW PIONEER CT STE E
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-9623
Practice Address - Country:US
Practice Address - Phone:503-303-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-08
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60042024183500000X
OR00113671835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
158048OtherNABP