Healthcare Provider Details

I. General information

NPI: 1710529870
Provider Name (Legal Business Name): PEARL SCHUMAN MSCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10806 SE 18TH CIR
VANCOUVER WA
98664-6194
US

IV. Provider business mailing address

10806 SE 18TH CIR
VANCOUVER WA
98664-6194
US

V. Phone/Fax

Practice location:
  • Phone: 360-826-8690
  • Fax:
Mailing address:
  • Phone: 360-298-4358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: