Provider Demographics
NPI:1235740499
Name:SCHAFF, MANDEEP PARMAR (MSN)
Entity Type:Individual
Prefix:
First Name:MANDEEP
Middle Name:PARMAR
Last Name:SCHAFF
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 15TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3750
Mailing Address - Country:US
Mailing Address - Phone:253-697-1310
Mailing Address - Fax:
Practice Address - Street 1:400 15TH AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3750
Practice Address - Country:US
Practice Address - Phone:253-697-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61079405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner