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NPI Code Detail

MEDICARE: JACQUELINE K SCHMIDT OT

MEDICARE: JACQUELINE K SCHMIDT OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist7148825-4201UT

General Provider Information

NPI Number : 1336171685
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE K SCHMIDT OT
Provider Business Mailing Address
First Line : 2423 S 3300 W
Second Line :
City : SYRACUSE
State : UT
Zip : 84075-5009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19930 BALLINGER WAY NE
Second Line :
City : SHORELINE
State : WA
Zip : 98155-1223
Country : US
Telephone Number : 206-363-6947
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 03/03/2010

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