Provider Demographics
NPI:1528727450
Name:MARASHI, SHOHREH
Entity type:Individual
Prefix:
First Name:SHOHREH
Middle Name:
Last Name:MARASHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S MEADOWS PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4877
Mailing Address - Country:US
Mailing Address - Phone:775-851-8060
Mailing Address - Fax:775-851-8061
Practice Address - Street 1:750 S MEADOWS PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4877
Practice Address - Country:US
Practice Address - Phone:775-851-8060
Practice Address - Fax:775-851-8061
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVKROAN2906253OtherANTHEM BLUE CROSS AND BLUE SHIELDS