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Individual
ELISE SHEPARD
Active
Individual
ELISE SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH00055983
WA
183500000X
Pharmacist
Primary
PHAP1558
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00055983
PHARMACY LICENSE
WA
01
—
PHAP1558
PHARMACY LICENSE
AK
Enumeration date
08/13/2020
Last updated
08/13/2020
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