Provider Demographics
NPI:1477059061
Name:SCHUBEL, SKYLER BRYCE WOLFGANG (DMD)
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:BRYCE WOLFGANG
Last Name:SCHUBEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 15TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2304
Mailing Address - Country:US
Mailing Address - Phone:206-783-7700
Mailing Address - Fax:
Practice Address - Street 1:6111 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-2304
Practice Address - Country:US
Practice Address - Phone:206-783-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609477711223G0001X, 1223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice