Provider Demographics
NPI:1679659965
Name:SCHILT, STEPHEN NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NEAL
Last Name:SCHILT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7609 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-1060
Mailing Address - Country:US
Mailing Address - Phone:253-565-5376
Mailing Address - Fax:253-565-5376
Practice Address - Street 1:7609 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-1060
Practice Address - Country:US
Practice Address - Phone:253-565-5376
Practice Address - Fax:253-565-5376
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000208122084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1303403Medicaid
WA1303403Medicaid