Provider Demographics
NPI:1407915028
Name:SCHMID, JERRY L (RPH)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:L
Last Name:SCHMID
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 19TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4303
Mailing Address - Country:US
Mailing Address - Phone:206-783-1701
Mailing Address - Fax:
Practice Address - Street 1:747 BROADWAY
Practice Address - Street 2:SWEDISH MEDICAL CENTER PHARMACY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4379
Practice Address - Country:US
Practice Address - Phone:206-386-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist