Provider Demographics
NPI:1336125749
Name:SHINBO, CAROL TAMI (RPH)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:TAMI
Last Name:SHINBO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:TAMI
Other - Last Name:SHINBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:6748 SE 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2500
Mailing Address - Country:US
Mailing Address - Phone:206-236-2525
Mailing Address - Fax:
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:SUITE 210
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:425-899-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist