Provider Demographics
NPI:1528003100
Name:SCHENCK, S. LENNART (MD)
Entity Type:Individual
Prefix:MR
First Name:S. LENNART
Middle Name:
Last Name:SCHENCK
Suffix:
Gender:M
Credentials:MD
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 24503
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0503
Mailing Address - Country:US
Mailing Address - Phone:425-451-4141
Mailing Address - Fax:425-451-4144
Practice Address - Street 1:1035 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4604
Practice Address - Country:US
Practice Address - Phone:425-451-4141
Practice Address - Fax:425-451-4144
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019395207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1134907Medicaid
WA0118359OtherL&I INDIVIDUAL
WA0118359OtherL&I INDIVIDUAL
WAA09188Medicare UPIN