Provider Demographics
NPI:1972613792
Name:KNOPP, SHAGHAYEGH B (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SHAGHAYEGH
Middle Name:B
Last Name:KNOPP
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 1:24991 HIGHWAY 126
Mailing Address - Street 2:
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487-9459
Mailing Address - Country:US
Mailing Address - Phone:541-935-2201
Mailing Address - Fax:541-935-8950
Practice Address - Street 1:24991 HIGHWAY 126
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487-9459
Practice Address - Country:US
Practice Address - Phone:541-935-2201
Practice Address - Fax:541-935-8950
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist