Healthcare Provider Details

I. General information

NPI: 1720061583
Provider Name (Legal Business Name): WADE SCHUTZE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 DENVER AVE S
SEATTLE WA
98134-2316
US

IV. Provider business mailing address

7102 130TH ST SE
SNOHOMISH WA
98296-7698
US

V. Phone/Fax

Practice location:
  • Phone: 206-763-2626
  • Fax: 206-767-1397
Mailing address:
  • Phone: 425-357-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00009076
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: