Provider Demographics
NPI:1013043454
Name:SCHMITZ, NANCY KAY (LMP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:KAY
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 PILCHUCK DR
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-8200
Mailing Address - Country:US
Mailing Address - Phone:360-387-2005
Mailing Address - Fax:
Practice Address - Street 1:1283 ELGER BAY RD
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8375
Practice Address - Country:US
Practice Address - Phone:360-387-4502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016656171W00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171W00000XOther Service ProvidersContractor
Not Answered174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA189916OtherLABOR AND INDUSTRIES
WA7132SCOtherREGENCE BLUE SHIELD