Shannon Katherine Kimball, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

RPH-0019145 Issued in OR

Practice address

364 SE 8TH Ave Ste 107
Hillsboro, OR 97123-4243

Phone

(503) 681-1338

NPI assigned

Dec 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tuality Healthcare

  • Psychiatric Hospital
  • Hillsboro, OR
  • NPI 1073817714
  NPD (past)

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1679286140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 NW ANASTASIA DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298502",
            "telephone_number": "503-621-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 SE 8TH AVE STE 107",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234243",
            "telephone_number": "503-681-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "SHANNON",
        "middle_name": "KATHERINE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OR",
            "license": "RPH-0019145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurianne Guce Kim, PTA, BS
• Michael Charles Kim, DMD
• Ryoka Kim, PH.D., L.P.
• Viviana Kim
• Kimani Psychiatry
• Janet Kindschuh, DPT
• David Jay King, D.C.
• Mary King
• John Kingman, MD
• Laura Kingston, OTR/L

• Ambulatory Care Pharmacist in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Ambulatory Care Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.