MEDICARE: SUSAN SCHMITT

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
1	225400000X	Rehabilitation Practitioner	MD00034988	WA

General Provider Information

NPI Number	:	1427228980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN SCHMITT

Provider Business Mailing Address
First Line	:	3213 EASTLAKE AVE E APT A
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-7127
Country	:	US
Telephone Number	:	206-861-8200
Fax Number	:	206-324-1178

Provider Business Practice Location Address
First Line	:	3213 EASTLAKE AVE E APT A
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-7127
Country	:	US
Telephone Number	:	206-861-8200
Fax Number	:	206-324-1178

Authorized Official
Title or Position	:	MD
Name	:	SUSAN SCHMITT
Credential	:
Telephone Number	:	206-861-8200

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/11/2008

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