Healthcare Provider Details

I. General information

NPI: 1164758272
Provider Name (Legal Business Name): LINDA JO SCHMEETS LMP, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 COMMERCE AVE
LONGVIEW WA
98632
US

IV. Provider business mailing address

PO BOX 1584
CASTLE ROCK WA
98611-1584
US

V. Phone/Fax

Practice location:
  • Phone: 360-355-6875
  • Fax:
Mailing address:
  • Phone: 360-355-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA00023058
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: