Provider Demographics
NPI:1033141007
Name:SCHNEIDERMAN, TODD EVAN (MD)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:EVAN
Last Name:SCHNEIDERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22232 17TH AVE SE STE 308
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7425
Mailing Address - Country:US
Mailing Address - Phone:425-296-3837
Mailing Address - Fax:206-215-3870
Practice Address - Street 1:9800 LEVIN RD NW
Practice Address - Street 2:SUITE 203
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7849
Practice Address - Country:US
Practice Address - Phone:360-307-0300
Practice Address - Fax:360-307-0302
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033488207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7129216Medicaid
WAG8853996Medicare PIN
WA7129216Medicaid