Provider Demographics
NPI:1023175759
Name:SCHMIDT, CLOTILDE JEANNE (DC)
Entity type:Individual
Prefix:
First Name:CLOTILDE
Middle Name:JEANNE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CLEVELAND AVE SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-3310
Mailing Address - Country:US
Mailing Address - Phone:360-943-6015
Mailing Address - Fax:360-943-2807
Practice Address - Street 1:310 CLEVELAND AVE SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-3310
Practice Address - Country:US
Practice Address - Phone:360-943-6015
Practice Address - Fax:360-943-2807
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor