Provider Demographics
NPI:1407936495
Name:SCHNEEWEISS, RONALD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SCHNEEWEISS
Suffix:
Gender:M
Credentials:
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 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:UWMC-ROOSEVELT
Practice Address - Street 2:4245 ROOSEVELT WAY NE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4770
Practice Address - Country:US
Practice Address - Phone:206-598-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1478OtherINTERNAL ID-MOTOR VEHICLE ID
WA8407702Medicaid
1478OtherINTERNAL ID-MOTOR VEHICLE ID
A05571Medicare UPIN