Provider Demographics
NPI:1841662251
Name:LIE, SHAWLIEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAWLIEN
Middle Name:
Last Name:LIE
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 1:9030 BROOKS RD S
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-7811
Mailing Address - Country:US
Mailing Address - Phone:707-837-8868
Mailing Address - Fax:707-837-8870
Practice Address - Street 1:9030 BROOKS RD S
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-7811
Practice Address - Country:US
Practice Address - Phone:707-837-8868
Practice Address - Fax:707-837-8870
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-24
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist