Healthcare Provider Details

I. General information

NPI: 1407462005
Provider Name (Legal Business Name): ABIGAIL RAE-ANN SCHNEIDER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 09/18/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 NW NYE ST STE C
PULLMAN WA
99163-3404
US

IV. Provider business mailing address

1220 NW STATE ST APT 20
PULLMAN WA
99163-3349
US

V. Phone/Fax

Practice location:
  • Phone: 509-332-2225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA61102740
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: