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General NPI Number Information
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NPI Number | 1477699726
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Entity Type | Individual
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Provider Name | ALBERT LAWRENCE SCHOCH PAC
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17TH & C STREET BUILDING 11582 OKYBO HEALTH CLINIC
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City | FORT LEWIS
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State | WA
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Zip | 98433
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Country | US
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Telephone | 253-966-7545
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Fax | 253-966-7653
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Provider Business Mailing Address
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Address Line | 8807 111TH ST CT SW
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City | LAKEWOOD
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State | WA
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Zip | 98498
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Country | US
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Telephone | 253-984-0928
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Fax | 253-966-7653
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PACCERTIFICATION#100
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License Number State |
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