Provider Demographics
NPI:1144972308
Name:DOWLATSHAHI, SHAHAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAHAM
Middle Name:
Last Name:DOWLATSHAHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 S PITTSBURG ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3573
Mailing Address - Country:US
Mailing Address - Phone:312-509-3198
Mailing Address - Fax:
Practice Address - Street 1:9120 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1202
Practice Address - Country:US
Practice Address - Phone:509-434-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61185717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist