Provider Demographics
NPI:1184855413
Name:SCHREINER, RUSTIN ROBERT (DC)
Entity Type:Individual
Prefix:
First Name:RUSTIN
Middle Name:ROBERT
Last Name:SCHREINER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18909 34TH AVE E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98446-1166
Mailing Address - Country:US
Mailing Address - Phone:253-219-5960
Mailing Address - Fax:253-236-4626
Practice Address - Street 1:1101 SUPERMALL WAY STE 1269
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-6535
Practice Address - Country:US
Practice Address - Phone:253-269-0261
Practice Address - Fax:253-269-0202
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60101664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor