Healthcare Provider Details

I. General information

NPI: 1063033900
Provider Name (Legal Business Name): MACKENZIE ANNETTE SCHUMANN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MACKENZIE ANNETTE MORROW FNP

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 06/16/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 S MERIDIAN STE 101
PUYALLUP WA
98371-7590
US

IV. Provider business mailing address

1703 S MERIDIAN STE 101
PUYALLUP WA
98371-7590
US

V. Phone/Fax

Practice location:
  • Phone: 253-848-3000
  • Fax: 253-447-1641
Mailing address:
  • Phone: 253-848-3000
  • Fax: 253-447-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRNP240875
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61680013
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: