Provider Demographics
NPI:1578642500
Name:SCHNELLER, ROSANNE F (OD)
Entity Type:Individual
Prefix:DR
First Name:ROSANNE
Middle Name:F
Last Name:SCHNELLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 E ALDER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2073
Mailing Address - Country:US
Mailing Address - Phone:509-527-3937
Mailing Address - Fax:509-529-4750
Practice Address - Street 1:614 E ALDER ST STE 1
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2073
Practice Address - Country:US
Practice Address - Phone:509-527-3937
Practice Address - Fax:509-529-4750
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1914TX152W00000X
OR1947T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2017911Medicaid
WA2017911Medicaid