Provider Demographics
NPI:1891823274
Name:SCHOENFELDER, ANGELIC (LMP)
Entity Type:Individual
Prefix:
First Name:ANGELIC
Middle Name:
Last Name:SCHOENFELDER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9505 19TH AVE SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3853
Mailing Address - Country:US
Mailing Address - Phone:425-379-8120
Mailing Address - Fax:425-338-1789
Practice Address - Street 1:9505 19TH AVE SE
Practice Address - Street 2:SUITE 101
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3853
Practice Address - Country:US
Practice Address - Phone:425-379-8120
Practice Address - Fax:425-338-1789
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016836225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0166448OtherDEPT OF L&I PIN