Provider Demographics
NPI:1790882843
Name:SCHULZ, KEITH E (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:E
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:DC
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 863
Mailing Address - Street 2:
Mailing Address - City:AIRWAY HEIGHTS
Mailing Address - State:WA
Mailing Address - Zip Code:99001-0863
Mailing Address - Country:US
Mailing Address - Phone:509-244-4818
Mailing Address - Fax:509-244-8945
Practice Address - Street 1:12727 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:AIRWAY HEIGHTS
Practice Address - State:WA
Practice Address - Zip Code:99001-9409
Practice Address - Country:US
Practice Address - Phone:509-244-4818
Practice Address - Fax:509-244-8945
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT-86893Medicare UPIN
WAAB39093Medicare ID - Type UnspecifiedMEDICARE