Provider Demographics
NPI:1275945651
Name:SCHROEDER, ELIZABETH PAMELA (LPN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:PAMELA
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3400
Mailing Address - Country:US
Mailing Address - Phone:253-301-6400
Mailing Address - Fax:
Practice Address - Street 1:1313 BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3400
Practice Address - Country:US
Practice Address - Phone:253-301-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP61500470164W00000X
OR202008252LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse