Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SHAWNA MARIE MIKKELSEN, PHARMD
ActivePharmacist Clinician (PhC) · MOSCOW, ID
Registration Details
- NPI Number
- 1770984817
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 9, 2014 (11.615492068609 yrs)
- Last Updated
- Sep 4, 2025
- Licenses
-
PH60232295 (WA)RPH61612 (CA)RPH61612 (CA)PH60232295 (WA)
Practice Information
- Address
-
700 S MAIN STMOSCOW, ID, 838433046Browse ID providers · Browse ZIP 83843
- Phone
- 2088832236
- Fax
- 2088836550
- Primary Specialty
-
Pharmacist Clinician (PhC)
1835P0018X
- Additional Specialty
- Pharmacotherapy Specialist
- Additional Specialty
- Pharmacist Clinician (PhC)
- Additional Specialty
- Pharmacotherapy Specialist
Other Pharmacist Clinician (PhC) Providers in MOSCOW, ID
| Name | Credential | NPI |
|---|---|---|
| DR. JESSE ANDREW RAPP | — | 1710312178 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.