Healthcare Provider Details

I. General information

NPI: 1124352950
Provider Name (Legal Business Name): SHEILA SCHAAL RD,LD,CSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2009
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

IV. Provider business mailing address

2459 HALLEBERRY
HAYDEN ID
83835-8339
US

V. Phone/Fax

Practice location:
  • Phone: 208-625-5084
  • Fax:
Mailing address:
  • Phone: 208-762-6761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number862927
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number862927
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number862927
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: