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NPI 1700395787

NPI 1700395787 : GRACE ELIZABETH SCHUMACHER RD : PALMER, AK

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General NPI Number Information
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    NPI Number           |    1700395787
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    Entity Type          |    Individual 
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    Provider Name        |    GRACE ELIZABETH SCHUMACHER RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/22/2017
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    Last Update Date     |    03/12/2026
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Provider Practice Location Address
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    Address Line         |    10355 E PALMER WASILLA HWY # 120-A 
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    City                 |    PALMER
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    State                |    AK
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    Zip                  |    99645-8876
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    Country              |    US
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    Telephone            |    469-275-4507
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    Fax                  |    469-278-6762
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Provider Business Mailing Address
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    Address Line         |    1150 S. COLONY WAY STE 3, PMB 269
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    City                 |    PALMER
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    State                |    AK
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    Zip                  |    99645-6972
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    Country              |    US
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    Telephone            |    907-631-9005
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    Fax                  |    
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    247100
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    License Number State |    AK
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Taxonomy #2
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    Taxonomy Code        |    225XF0002X
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    Taxonomy Name        |    Feeding, Eating & Swallowing Occupational Therapist
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    License Number       |    247100
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    License Number State |    AK
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Taxonomy #3
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    105564
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    License Number State |    AK
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Taxonomy #4
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    Taxonomy Code        |    225XM0800X
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    Taxonomy Name        |    Mental Health Occupational Therapist
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    License Number       |    247100
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    License Number State |    AK
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