Provider Demographics
NPI:1659469047
Name:SCHAUER, GWENDOLYN M (DC)
Entity Type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:M
Last Name:SCHAUER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:MARIE
Other - Last Name:SCHAUER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:3525 ENSIGN RD NE STE G
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5065
Mailing Address - Country:US
Mailing Address - Phone:360-705-1116
Mailing Address - Fax:360-236-0535
Practice Address - Street 1:3525 ENSIGN RD NE STE G
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5065
Practice Address - Country:US
Practice Address - Phone:360-705-1116
Practice Address - Fax:360-236-0535
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2556111N00000X
WACH00002556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA105993OtherDEPT OF L&I
WASC4593OtherREGENCE
WA2021871Medicaid
WA105993OtherDEPT OF L&I
WAU23803Medicare UPIN