Provider Demographics
NPI:1013227933
Name:SCHILLER, JENNIFER R (LMT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:R
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:R
Other - Last Name:HOLLAND-BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:4087 SE THELMA LANE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367
Mailing Address - Country:US
Mailing Address - Phone:360-621-2934
Mailing Address - Fax:
Practice Address - Street 1:1616 SE ELLIS CT
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367
Practice Address - Country:US
Practice Address - Phone:360-621-2934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60182494171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor