Individual provider Active NPI

Shannon Nicole Oveson, PHARMD

  • Pharmacist
  • Olympia, WA
National Provider Identifier
1063997609
Registry record updated Sep 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60874943 Issued in WA
Practice address
4280 Martin Way E
Olympia, WA 98516-5354
Phone
(360) 456-0709
NPI assigned
Sep 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60874943 WA Primary

Addresses

Primary practice location

4280 Martin Way E
Olympia, WA 98516-5354

Mailing address

6009 Capitol Blvd SW Apt 204
Tumwater, WA 98501-5296
Phone (801) 703-6959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH60874943WAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538179200000",
    "number": "1063997609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 CAPITOL BLVD SW APT 204",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015296",
            "telephone_number": "801-703-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 MARTIN WAY E",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165354",
            "telephone_number": "360-456-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVESON",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-29",
        "last_updated": "2018-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60874943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.