SHANE M ANDERSON (NPI# 1639461635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639461635 |
| Entity Type | Individual |
| Full Name | SHANE M ANDERSON |
| Credential | PHD |
| Practice Address |
402 S 4th Ave Yakima WA 98902-3546 |
| Mailing Address |
Po Box 959 Yakima WA 98907-0959 |
| Practice Telephone | 5095754084 |
| Mailing Telephone | 5095754084 |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
PH60215206 | WA | Pharmacy Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295168433 | Shane Robert Anderson | Otolaryngology | 1106 Beechwood St, Hillcrest, Little Rock, AR 72205 | 2013-08-12 |
| 1750513040 | Shane Michael Anderson | Counselor | 1643 Sr 104, Chillicothe, OH 45601 | 2009-08-20 |
| 1841289659 | Shane Keith Anderson | Internal Medicine | 220 Bannock St, Malad City, ID 83252-1256 | 2005-10-14 |
| 1952863946 | Shane Corbin Anderson | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2019-04-01 |
| 1720523418 | Shane David Anderson | Nurse Practitioner | 6316 Old Oak Ridge Rd, Greensboro, NC 27410-9939 | 2017-01-04 |
| 1497002299 | Shane S Anderson | Pharmacist | 1502 N Vercler Rd, Spokane Valley, WA 99216 | 2012-08-10 |
| 1144208661 | Shane Blake Anderson | Nuclear Medicine | 3551 Roger Brooke Dr, Brooke Army Medical Center, Fort Sam Houston, TX 78234-4504 | 2006-01-04 |
| 1952383432 | Shane Selassie Anderson | Pathology | 1001 Sw Klickitat Way, 205, Seattle, WA 98134-1161 | 2005-11-18 |
| Street Address |
402 S 4TH AVE |
| City | YAKIMA |
| State | WA |
| Zip Code | 98902-3546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811996200 | John Edward Omalley | Psychiatry & Neurology | 402 S 4th Ave, Yakima, WA 98902-3546 | 2005-07-18 |
| 1407453715 | Mariah Forgey | Social Worker | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-10-08 |
| 1821602251 | David Mejia Juarez | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-09-02 |
| 1184238503 | Aleque Fraser-robinson | Peer Specialist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-09-02 |
| 1093326498 | Casey Eugene Olson | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-08-11 |
| 1891305124 | Whitney Gregory | Social Worker | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-08-02 |
| 1053936203 | Paulina Alcala | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| 1972128122 | Mercedes Cardenas | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| 1699390849 | Luis Garcia | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| 1134744386 | Cynthia Deleon | Counselor | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653203 | Laboratory Corporation of America | Clinical Medical Laboratory | 314 S 11th Ave Suite A, Yakima, WA 98902 | 2019-08-05 |
| 1669967865 | Rebecca Schrader | Speech-Language Pathologist | Children's Village 3801 Kern Road, Yakima, WA 98902 | 2018-06-29 |
| 1720572928 | Hyperbaric Centers of Washington | Preventive Medicine | 302 S. 12th Ave., Yakima, WA 98902 | 2018-06-20 |
| 1487155503 | Courtney Lombardi | Nurse Practitioner | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-02-23 |
| 1003329665 | Maria-elena Mendoza | Case Manager/Care Coordinator | 918 E Mead Avenue, Yakima, WA 98902 | 2017-11-06 |
| 1679017610 | Claudia Zepeda | Massage Therapist | 3908 Creekside Loop Ste # 110, Yakima, WA 98902 | 2016-12-09 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
| 1821490905 | Jen Lynn Silver | Massage Therapist | 3512 Tieton Dr, Yakima, WA 98902 | 2014-09-20 |
| 1194131383 | Brenna Claire Hayes | Genetic Counselor, MS | 2903 W Walnut, Yakima, WA 98902 | 2014-07-08 |
| 1720400435 | Agnes Nadine Jeske | Speech-Language Pathologist | 621 S. 13th Ave., Mckinley Elementary School, Yakima, WA 98902 | 2014-01-15 |
| Find all providers in zip 98902 | ||||
| Taxonomy Code | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962957936 | Aubrie Duke | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2016-08-19 |
| 1194109942 | Laura Powers | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2015-07-10 |
| 1609259662 | Glen Chase | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2015-07-08 |
| 1649248949 | Angelo Anthony Ballasiotes | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114042728 | George Edward Key Jr. | Pharmacist | 28716 Ne Zeek Rd, Washougal, WA 98671-9266 | 2007-03-20 |
| 1417955048 | Brandy Singer | Pharmacist | 3502 South Mcdonald Road, Spokane Valley, WA 99206 | 2005-07-08 |
| 1225035728 | Frederick Steven Jestrab | Pharmacist | 9601 Steilacoom Blvd Sw, Western State Hospital- Mail Stop 13-100, Tacoma, WA 98498-7213 | 2005-06-30 |
| 1063022861 | Christina Hope Randle | Pharmacist | 9601 Steilacoom Blvd Sw, Lakewood, WA 98498-7212 | 2020-08-06 |
| 1609344084 | Luke Austin Dzirbik | Pharmacist | 9601 Steilacoom Blvd Sw, Lakewood, WA 98498-7212 | 2018-11-05 |
| 1255871059 | Noor Daghistani | Pharmacist | 9601 Steilacoom Blvd Sw, Lakewood, WA 98498-7212 | 2017-02-28 |
| 1316303852 | Mohammad Shawish | Pharmacist | 14701 179th Ave Se, Monroe, WA 98272-1108 | 2016-01-14 |
| 1720408719 | Kyung Thompson | Pharmacist | 9601 Steilacoom Blvd Sw, Tacoma, WA 98498-7212 | 2014-04-17 |
| 1437407798 | Chelsea Jo Markle | Pharmacist | 325 9th Ave, Seattle, WA 98104-2420 | 2012-08-16 |
| 1497001481 | Rob Leland | Pharmacist | 6 E 1st Ave, Spokane, WA 99202-1503 | 2012-07-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.