1669966909 NPI number — MRS. PAULA RENEE SCHAEFER APRN-NURSE PRACTITIO

Table of content: MRS. PAULA RENEE SCHAEFER APRN-NURSE PRACTITIO (NPI 1669966909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669966909 NPI number — MRS. PAULA RENEE SCHAEFER APRN-NURSE PRACTITIO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHAEFER
Provider First Name:
PAULA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN-NURSE PRACTITIO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHEMMER
Provider Other First Name:
PAULA
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669966909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 73488
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PUYALLUP
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98373-0488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-722-9700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2219 RIMLAND DR STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98226-8759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-722-9700
Provider Business Practice Location Address Fax Number:
844-222-0800
Provider Enumeration Date:
06/20/2018

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: 363L00000X , with the licence number:  AP60966080 , 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: AP60966080 . This is a "WA LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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