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General NPI Number Information
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NPI Number | 1235377987
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Entity Type | Organization
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Legal Business Name | ALPINE LAKES FAMILY PRACTICE, PLLC
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 112 W RAILROAD ST SUITE #200
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City | CLE ELUM
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State | WA
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Zip | 98922-1131
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Country | US
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Telephone | 509-674-5344
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Fax | 509-674-5704
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Provider Business Mailing Address
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Address Line | 112 W RAILROAD ST SUITE #200
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City | CLE ELUM
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State | WA
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Zip | 98922-1131
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Country | US
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Telephone | 509-674-5344
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Fax | 509-674-5704
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SAMUEL E SCHNEIDER
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Credential | DO
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Telephone | 509-674-5344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OP00002272
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License Number State | WA
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