Healthcare Provider Details

I. General information

NPI: 1427228980
Provider Name (Legal Business Name): SUSAN SCHMITT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3213 EASTLAKE AVE E APT A
SEATTLE WA
98102-7127
US

IV. Provider business mailing address

3213 EASTLAKE AVE E APT A
SEATTLE WA
98102-7127
US

V. Phone/Fax

Practice location:
  • Phone: 206-861-8200
  • Fax: 206-324-1178
Mailing address:
  • Phone: 206-861-8200
  • Fax: 206-324-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberMD00034988
License Number StateWA

VIII. Authorized Official

Name: SUSAN SCHMITT
Title or Position: MD
Credential:
Phone: 206-861-8200