Provider Demographics
NPI:1962671198
Name:SCHAEFER, LORI (LMP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:SCHAEFER
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 1:10137 MAIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3441
Mailing Address - Country:US
Mailing Address - Phone:206-595-1888
Mailing Address - Fax:916-488-4906
Practice Address - Street 1:10137 MAIN ST STE 8
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3441
Practice Address - Country:US
Practice Address - Phone:206-595-1888
Practice Address - Fax:916-488-4906
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012815225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist