Healthcare Provider Details

I. General information

NPI: 1598786170
Provider Name (Legal Business Name): LUANN E SCHAFER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 3RD ST SE STE 240
PUYALLUP WA
98372-3771
US

IV. Provider business mailing address

1322 3RD ST SE STE 240
PUYALLUP WA
98372-3771
US

V. Phone/Fax

Practice location:
  • Phone: 253-697-1420
  • Fax:
Mailing address:
  • Phone: 253-697-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30003671
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: