Provider Demographics
NPI:1821144742
Name:SCHNEIDERMAN, AUBRIANNE MICHELLE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:AUBRIANNE
Middle Name:MICHELLE
Last Name:SCHNEIDERMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MISS
Other - First Name:AUBRIANNE
Other - Middle Name:MICHELLE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:3229 S 302ND PL
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-2200
Mailing Address - Country:US
Mailing Address - Phone:360-990-6592
Mailing Address - Fax:253-857-3624
Practice Address - Street 1:871 BETHEL AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4229
Practice Address - Country:US
Practice Address - Phone:360-990-6592
Practice Address - Fax:253-857-3624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021333225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist