Individual
SHANNON WATHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
13420 W COAL MINE AVE, LITTLETON, CO 80127-5402
(303) 979-2870
(303) 979-5091
Mailing address
4334 S COLE CT, MORRISON, CO 80465-1147
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21028
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21028
PHARMACY LICENSE
CO
Enumeration date
04/29/2019
Last updated
04/29/2019
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