Provider Demographics
NPI:1942206313
Name:SHIRLEY, KERRIE LEE (PHARMD, BCPS, BCPP)
Entity Type:Individual
Prefix:DR
First Name:KERRIE
Middle Name:LEE
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:PHARMD, BCPS, BCPP
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:LEE
Other - Last Name:SHIRLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, BCPS, BCPP
Mailing Address - Street 1:1250 N WENATCHEE AVE SUITE H PMB 352
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-593-8728
Mailing Address - Fax:509-470-8562
Practice Address - Street 1:522 W RIVERSIDE AVE STE 8238
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0580
Practice Address - Country:US
Practice Address - Phone:509-593-8728
Practice Address - Fax:509-470-8562
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-044967L183500000X
ORRPH014459183500000X, 1835P1300X, 1835P2201X, 1835P0018X, 1835P1200X
PARP044967L1835P0018X, 1835G0303X, 1835P1300X, 1835P1200X
WAPH609804461835P0018X, 1835P2201X, 1835P1200X, 1835P1300X
MEPR57091835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy