IndividualActive
Shinta Imansjah, PHARM D/RPH
NPI 1457314353 · Pharmacist · Portland, OR
Provider details
- NPI number
- 1457314353
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- PHARM D/RPH
- Sex
- Female
- Sole proprietor
- No
- License
- PH61290107 (WA)
Specialties & taxonomies
Pharmacy Service Providers
Pharmacy Service Providers
Pharmacy Service Providers
Profile Score
Detailed profile(95/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12360 E Burnside St
Portland, OR 97233-1042
Phone: (971) 279-4800
Fax: (971) 279-2763
Street-level locationGet directions
Mailing address
211 Se Caruthers St
Portland, OR 97214-4502
Additional practice locations (1)
- 703 Ne Hancock StPortland, OR 97212-3955Phone: (503) 230-9875Fax: (503) 331-2677
Registry dates
- Enumerated
- 2006-04-11
- Last updated
- 2025-04-09
- Certified
- 2025-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.