Provider Demographics
NPI:1891783791
Name:SCHNEIDER, RICHARD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:SCHNEIDER
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 1:7116 84TH ST NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-6738
Mailing Address - Country:US
Mailing Address - Phone:253-858-7554
Mailing Address - Fax:
Practice Address - Street 1:3609 S 19TH ST
Practice Address - Street 2:BELLMORE PROFESSIONAL BUILDING
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1918
Practice Address - Country:US
Practice Address - Phone:253-752-6056
Practice Address - Fax:253-759-7129
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 262942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1160118Medicaid
WAE98277Medicare UPIN
WAAB11195Medicare ID - Type Unspecified