Provider Demographics
NPI:1932199726
Name:HOLDEN, SHANNON L (PHARMD, RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:L
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 W ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9284
Mailing Address - Country:US
Mailing Address - Phone:509-467-1682
Mailing Address - Fax:
Practice Address - Street 1:6002 N LIDGERWOOD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1124
Practice Address - Country:US
Practice Address - Phone:509-241-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00039003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist