Individual provider Active NPI

Mariah Shoffner, PHARMD

  • Pharmacist
  • Coos Bay, OR
National Provider Identifier
1396525770
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0019727 Issued in OR
Practice address
630 Miluk Dr
Coos Bay, OR 97420-7728
Phone
(541) 435-7039
Fax
(541) 982-5352
NPI assigned
Oct 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0019727 OR Primary

Addresses

Primary practice location

630 Miluk Dr
Coos Bay, OR 97420-7728

Mailing address

630 Miluk Dr
Coos Bay, OR 97420-7728
Phone (541) 435-7039

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
RPH-0019727ORMDPharmacist

Interoperability endpoints

  • Direct secure messaging: mariah.shoffner.p2@direct.coquilletribe.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1396525770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 MILUK DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207728",
            "telephone_number": "541-435-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MILUK DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207728",
            "telephone_number": "541-435-7039",
            "fax_number": "541-982-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOFFNER",
        "first_name": "MARIAH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0019727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.