Provider Demographics
NPI:1639152283
Name:SCHNEIDER, RICHARD HAROLD JR (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HAROLD
Last Name:SCHNEIDER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 S 293RD ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-3694
Mailing Address - Country:US
Mailing Address - Phone:253-946-4850
Mailing Address - Fax:253-838-0875
Practice Address - Street 1:32717 1ST AVE S
Practice Address - Street 2:SUITE 6
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5758
Practice Address - Country:US
Practice Address - Phone:253-838-5428
Practice Address - Fax:253-838-0975
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00001448152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2027654Medicaid
WAAB22674Medicare ID - Type Unspecified
WA2027654Medicaid