Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shinta Imansjah, PHARMD/RPH

Individual provider Pharmacist · NPI 1457314353

Shinta Imansjah, PHARMD/RPH is a Pharmacist in Portland, Oregon. Works from 2 locations. Licensed in Florida, Oregon and Washington.

Licensed in
FL, OR, WA
In the registry since
2006
Specialties on file
3

Practice location Address checks out

12360 E Burnside St
Portland, OR 97233-1042
Phone: (971) 279-4800
Fax: (971) 279-2763
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 703 Ne Hancock St, Portland, OR 97212-3955 — (503) 230-9875

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence RPH-0015242 (OR)
Pharmacist Taxonomy 183500000X · Licence PH61290107 (WA)
Pharmacist Taxonomy 183500000X · Licence PS 40904 (FL)

Record details

NPI number1457314353
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHARMD/RPH
Sole proprietorNo
NPI enumeratedApril 11, 2006
Last updated in NPPESApril 9, 2025
Certification dateApril 9, 2025

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