Provider Demographics
NPI:1659656353
Name:SCHNYDER, MICHAEL E (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:SCHNYDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 S KITSAP BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3709
Mailing Address - Country:US
Mailing Address - Phone:360-744-6275
Mailing Address - Fax:360-744-6270
Practice Address - Street 1:450 S KITSAP BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3709
Practice Address - Country:US
Practice Address - Phone:360-744-6275
Practice Address - Fax:360-744-6270
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60240552363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2038388Medicaid