1306828165 NPI number — THOMAS C. SCHWARTZ, DC, PS, INC.

Table of content: (NPI 1306828165)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306828165 NPI number — THOMAS C. SCHWARTZ, DC, PS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS C. SCHWARTZ, DC, PS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306828165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 LAKE BELLEVUE DR.
Provider Second Line Business Mailing Address:
SUITE #113
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-635-0544
Provider Business Mailing Address Fax Number:
425-450-0365

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 LAKE BELLEVUE DR.
Provider Second Line Business Practice Location Address:
SUITE #113
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-635-0544
Provider Business Practice Location Address Fax Number:
425-450-0365
Provider Enumeration Date:
11/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWARTZ
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
CHARLES
Authorized Official Title or Position:
CLINIC DIRECTOR/OWNER
Authorized Official Telephone Number:
425-635-0544

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH00002034 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 607181900 . This is a "OWCP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0125924 . This is a "DEPT. LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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