Healthcare Provider Details

I. General information

NPI: 1891798955
Provider Name (Legal Business Name): HOWARD SCHAENGOLD D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 228TH AVE NE
SAMMAMISH WA
98074-7209
US

IV. Provider business mailing address

466 228TH AVE NE
SAMMAMISH WA
98074-7209
US

V. Phone/Fax

Practice location:
  • Phone: 425-868-3338
  • Fax: 425-836-9211
Mailing address:
  • Phone: 425-868-3338
  • Fax: 425-836-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPO00000461
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO00000461
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: