Healthcare Provider Details

I. General information

NPI: 1063846350
Provider Name (Legal Business Name): LACEY LEE SCHENK DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2013
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8714 N DIVISION ST
SPOKANE WA
99218-1106
US

IV. Provider business mailing address

1755 BLUE CREEK RD W
ADDY WA
99101-9631
US

V. Phone/Fax

Practice location:
  • Phone: 509-467-5230
  • Fax:
Mailing address:
  • Phone: 509-936-1703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberVT 60363083
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: