MEDICARE: SCHINE HEALTH PLLC

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	363L00000X	Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1912786625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHINE HEALTH PLLC

Provider Business Mailing Address
First Line	:	105 N TOWER AVE
Second Line	:
City	:	CENTRALIA
State	:	WA
Zip	:	98531-4206
Country	:	US
Telephone Number	:	360-726-3754
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 N TOWER AVE
Second Line	:
City	:	CENTRALIA
State	:	WA
Zip	:	98531-4206
Country	:	US
Telephone Number	:	360-726-3754
Fax Number	:	360-925-2865

Authorized Official
Title or Position	:	ACCOUNT SPECIALIST
Name	:	LAURA L SPENCER-WAGNER
Credential	:
Telephone Number	:	970-529-3348

Provider Enumeration Date	:	09/22/2023
Last Update Date	:	03/12/2026

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