Provider Demographics
NPI:1730304494
Name:SCHORR, NINA L (MD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:L
Last Name:SCHORR
Suffix:
Gender:F
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:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:EAST OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98540-0004
Mailing Address - Country:US
Mailing Address - Phone:360-491-8002
Mailing Address - Fax:
Practice Address - Street 1:2910 E MADISON ST # 302
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4214
Practice Address - Country:US
Practice Address - Phone:206-860-2654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000374292084P0800X
NY135616-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAB80371Medicare UPIN
WAGAB26400Medicare PIN