1457614034 NPI number — DR. ILENE SHARON SCHWARTZ PH.D.

Table of content: DR. ILENE SHARON SCHWARTZ PH.D. (NPI 1457614034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457614034 NPI number — DR. ILENE SHARON SCHWARTZ PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZ
Provider First Name:
ILENE
Provider Middle Name:
SHARON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1457614034
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF WASHINGTON
Provider Second Line Business Mailing Address:
BOX 357925
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98195-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-616-3450
Provider Business Mailing Address Fax Number:
206-543-8480

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY OF WASHINGTON
Provider Second Line Business Practice Location Address:
BOX 357925
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-616-3450
Provider Business Practice Location Address Fax Number:
206-543-8480
Provider Enumeration Date:
06/19/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-01-0445 , 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)





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