Healthcare Provider Details

I. General information

NPI: 1669839064
Provider Name (Legal Business Name): ASHLEY RENAE SCHMAING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY VISSER

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 01/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 FACTORIA BLVD SE STE A
BELLEVUE WA
98006-1234
US

IV. Provider business mailing address

PO BOX 24105
SEATTLE WA
98124-0105
US

V. Phone/Fax

Practice location:
  • Phone: 425-903-3141
  • Fax: 425-903-3142
Mailing address:
  • Phone: 425-903-3141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60611636
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: