Provider Demographics
NPI:1205388220
Name:SCHROEDEL, SYDNEY CHRISTINE (LMT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:CHRISTINE
Last Name:SCHROEDEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 INTELCO LOOP SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-6004
Mailing Address - Country:US
Mailing Address - Phone:360-589-8622
Mailing Address - Fax:
Practice Address - Street 1:4510 INTELCO LOOP SE
Practice Address - Street 2:SUITE A
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-6004
Practice Address - Country:US
Practice Address - Phone:360-402-6776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60689790225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist