Provider Demographics
NPI:1346259975
Name:RETINA CENTER NW, PLLC
Entity Type:Organization
Organization Name:RETINA CENTER NW, PLLC
Other - Org Name:TODD E SCHNEIDERMAN, MD, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHNEIDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-307-0300
Mailing Address - Street 1:9800 LEVIN RD NW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7849
Mailing Address - Country:US
Mailing Address - Phone:360-307-0300
Mailing Address - Fax:360-307-0302
Practice Address - Street 1:9800 LEVIN RD NW
Practice Address - Street 2:SUITE 203
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7849
Practice Address - Country:US
Practice Address - Phone:360-307-0300
Practice Address - Fax:360-307-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7129216Medicaid
WAG8853996Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER