Shannon Lin Cornell, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00067684 Issued in WA

Practice address

10302 156TH St E
Pharmacy Dept
Puyallup, WA 98374-9321

Phone

(253) 604-1067

Fax

(253) 604-1077

NPI assigned

Jun 3, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1942594296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10302 156TH ST E",
            "address_2": "PHARMACY DEPT",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983749321",
            "telephone_number": "253-604-1067",
            "fax_number": "253-604-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10302 156TH ST E",
            "address_2": "PHARMACY DEPT",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983749321",
            "telephone_number": "253-604-1067",
            "fax_number": "253-604-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "SHANNON",
        "middle_name": "LIN",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00067684",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "PH10679",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0006822W",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Aaron Edward Corey
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• Dorothy Lea Corliss, R.D.H.
• Kenneth J Corliss, OD
• Frances J Corn, MSW
• Lisa Corriell, LMP
• Ashley Cort
• Laura Ashley Cortez, MS, CCC-SLP
• Shirleidy Mirelle Costa Freitas Stratton
• Costco Wholesale Corporation

• Pharmacist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.