MEDICARE: CASSANDRA SCHNELLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT60848939	WA
2	225100000X	Physical Therapist	2305211697	VA
3	225100000X	Physical Therapist	05012740A	IN

General Provider Information

NPI Number	:	1861990178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA SCHNELLE

Provider Business Mailing Address
First Line	:	9616 O DAY DR
Second Line	:
City	:	HIGHLAND
State	:	IN
Zip	:	46322-3158
Country	:	US
Telephone Number	:	219-433-0462
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 SE 192ND AVE STE 205
Second Line	:
City	:	CAMAS
State	:	WA
Zip	:	98607-7415
Country	:	US
Telephone Number	:	360-210-5440
Fax Number	:	360-210-7731

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2018
Last Update Date	:	10/09/2019

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Directions to “ CASSANDRA SCHNELLE ” Practice Location

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