Provider Demographics
NPI:1891825675
Name:SCHRAM, REID (LMP)
Entity Type:Individual
Prefix:
First Name:REID
Middle Name:
Last Name:SCHRAM
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ST SE STE A
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5200
Mailing Address - Country:US
Mailing Address - Phone:360-786-8600
Mailing Address - Fax:360-786-8603
Practice Address - Street 1:200 W ST SE STE A
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-5200
Practice Address - Country:US
Practice Address - Phone:360-786-8600
Practice Address - Fax:360-786-8603
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020823174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA209052OtherLABOR AND INDUSTRIES