SHINTA IMANSJAH PHARM D/RPH
NPI 1457314353
Pharmacist in Portland, OR

Active since April 11, 2006
12360 E BURNSIDE ST, PORTLAND, OR 97233(971) 279-4800(971) 279-2763 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 9, 2025, Jun 2, 2023, May 10, 2021 and 3 more (6 updates tracked since 2019).

About Shinta Imansjah Pharm D/rph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHINTA IMANSJAH PHARM D/RPH (NPI 1457314353) is an individual pharmacist in Portland, Oregon, licensed in Oregon (RPH-0015242) and active in the NPI registry since April 2006. She maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1457314353
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameSHINTA IMANSJAHCredential: PHARM D/RPH
Location Address12360 E BURNSIDE STPortland, OR 97233-1042
Mailing Address211 Se Caruthers StPortland, OR 97214-4502 · (503) 224-1044 · Fax (971) 260-0355
Fax(971) 279-2763
Sole ProprietorNo
Enumeration DateApril 11, 2006
Last NPPES UpdateApril 9, 20256 updates tracked since enumeration
NPPES CertifiedApril 9, 2025
NPI 1457314353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
Licenses Licensed in OR · RPH-0015242 Licensed in WA · PH61290107 Licensed in FL · PS 40904
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
12360 E BURNSIDE ST, Portland, OR 97233

Secondary Practice Location 1

Location 1703 NE Hancock StPortland, OR 97212-3955 · Phone (503) 230-9875 · Fax (503) 331-2677

Other Identifiers 2

Medicaid500722920OR
Medicaid2306886WA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor
12360 E BURNSIDE ST
PORTLAND, OR 97233
Registered Nurse
12360 E BURNSIDE ST
PORTLAND, OR 97233
Peer Specialist
12360 E BURNSIDE ST
PORTLAND, OR 97233
Clinic/Center (Federally Qualified Health Center (FQHC))
12360 E BURNSIDE ST
PORTLAND, OR 97233
Social Worker
12360 E BURNSIDE ST
PORTLAND, OR 97233
Registered Nurse
12360 E BURNSIDE ST
PORTLAND, OR 97233
Social Worker (Clinical)
12360 E BURNSIDE ST
PORTLAND, OR 97233
Counselor (Mental Health)
12360 E BURNSIDE ST
PORTLAND, OR 97233

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shinta Imansjah's NPI number?

The NPI number for Shinta Imansjah is 1457314353. It was assigned to this individual provider in the NPPES registry on April 11, 2006.

Where is Shinta Imansjah located?

Shinta Imansjah practices at 12360 E Burnside St, Portland, OR 97233. The listed phone number is (971) 279-4800.

What is Shinta Imansjah's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Shinta Imansjah was last updated on April 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.