Provider Demographics
NPI:1639525157
Name:SCHREIBMAN, SHELLEY GAIL
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:GAIL
Last Name:SCHREIBMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:GAIL
Other - Last Name:BRISTOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:101 N PARK STREET
Mailing Address - Street 2:PO BOX 909
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109
Mailing Address - Country:US
Mailing Address - Phone:509-935-4988
Mailing Address - Fax:509-935-4985
Practice Address - Street 1:101 N PARK STREET
Practice Address - Street 2:PO
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109
Practice Address - Country:US
Practice Address - Phone:509-935-4988
Practice Address - Fax:509-935-4985
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003171174400000X
WAPT 00003171174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist