Provider Demographics
NPI:1124190897
Name:SCHMIDT, PATRICK JOHN JR (PT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOHN
Last Name:SCHMIDT
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 W ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9284
Mailing Address - Country:US
Mailing Address - Phone:509-465-2649
Mailing Address - Fax:
Practice Address - Street 1:601 W 5TH AVE
Practice Address - Street 2:STE. 308
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2705
Practice Address - Country:US
Practice Address - Phone:509-467-1244
Practice Address - Fax:509-456-3608
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0181045OtherLABOR & INDUSTRIES
WA8333775Medicaid
WA0181045OtherLABOR & INDUSTRIES