Healthcare Provider Details

I. General information

NPI: 1992871487
Provider Name (Legal Business Name): HEATHER LYNETTE SCHULTZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PACIFIC AVE PEDIATRICS
EVERETT WA
98201-4168
US

IV. Provider business mailing address

13745 DENSMORE AVE N
SEATTLE WA
98133-7129
US

V. Phone/Fax

Practice location:
  • Phone: 425-304-6050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00044380
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: