Provider Demographics
NPI:1205080041
Name:JERI L SCHWEIGLER EDD INC PS
Entity type:Organization
Organization Name:JERI L SCHWEIGLER EDD INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JERI
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:SCHWEIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:425-454-2835
Mailing Address - Street 1:1300 116TH AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3820
Mailing Address - Country:US
Mailing Address - Phone:425-454-2835
Mailing Address - Fax:425-454-2315
Practice Address - Street 1:1300 116TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3820
Practice Address - Country:US
Practice Address - Phone:425-454-2835
Practice Address - Fax:425-454-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001349103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8878147Medicare PIN