Provider Demographics
NPI:1265446660
Name:STROEMEL, MATHIAS M (DO)
Entity Type:Individual
Prefix:
First Name:MATHIAS
Middle Name:M
Last Name:STROEMEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2292
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362
Mailing Address - Country:US
Mailing Address - Phone:509-522-5815
Mailing Address - Fax:509-522-5818
Practice Address - Street 1:301 W POPLAR
Practice Address - Street 2:SUITE 100
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362
Practice Address - Country:US
Practice Address - Phone:509-522-5824
Practice Address - Fax:509-522-5738
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP1416207RN0300X
KS05-48772207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8146383Medicaid
WAAB10123Medicare ID - Type Unspecified
WA8146383Medicaid