Shain Jessup Dammon, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

P5849 Issued in ID

Practice address

1203 Idaho St
Lewiston, ID 83501-1940

Phone

(208) 848-8290

Fax

(208) 848-8291

NPI assigned

Sep 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Chastains Inc

  • Community/Retail Pharmacy
  • Lewiston, ID
  • NPI 1245381094
  NPD (past)
• Chastains Inc

  • Long Term Care Pharmacy
  • Lewiston, ID
  • NPI 1689768145
  NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1326005851
  NPD (past)

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1780918342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "208-848-8290",
            "fax_number": "208-848-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 IDAHO ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011940",
            "telephone_number": "208-848-8290",
            "fax_number": "208-848-8291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 S Main St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838432695",
            "country_code": "US",
            "telephone_number": "208-848-8312",
            "fax_number": "208-882-5587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMMON",
        "first_name": "SHAIN",
        "middle_name": "JESSUP",
        "name_prefix": "Mr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-29",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "6968",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "6968696869",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaden Culp, DPT
• Heather Fowler Cumbo, MD
• Imelda Daley, M.S.
• Kyle James Daly, CRNA
• Ryan Joseph Daly, DNP
• Dan R Wilson DDS PC
• Jenna Darnell
• Kathryn Ashley Datkuliak, LMT
• David M Brown, Crna PS
• Barbara Kay Davis, MD

• All providers in Lewiston, ID
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.