Individual
SHANNON N BLANKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
60 DIVISION AVE, EUGENE, OR 97404-5127
(541) 461-1433
(541) 461-1443
Mailing address
60 DIVISION AVE, EUGENE, OR 97404-5127
(541) 461-1433
(541) 461-1443
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11448
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
11448
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11448
RPH LICENSE
OR
Enumeration date
11/08/2011
Last updated
04/25/2017
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