Provider Demographics
NPI:1679001747
Name:SCHAFFER, NATHANIEL ELLIOT (MD, PHD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:ELLIOT
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3726 BROADWAY STE 201
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3788
Mailing Address - Country:US
Mailing Address - Phone:425-317-9119
Mailing Address - Fax:
Practice Address - Street 1:3726 BROADWAY STE 201
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3788
Practice Address - Country:US
Practice Address - Phone:425-317-9119
Practice Address - Fax:425-317-9118
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301112013207X00000X
TN65391207XX0801X
WAMD61443193207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery