Provider Demographics
NPI:1245345560
Name:SCHWAB, HENRIETTE PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:HENRIETTE
Middle Name:PATRICIA
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34616 11TH PLACE SO
Mailing Address - Street 2:SUITE #5
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8705
Mailing Address - Country:US
Mailing Address - Phone:253-952-7277
Mailing Address - Fax:253-952-7280
Practice Address - Street 1:34616 11TH PLACE SO
Practice Address - Street 2:SUITE #5
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8705
Practice Address - Country:US
Practice Address - Phone:253-952-7277
Practice Address - Fax:253-952-7280
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025958207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD00025958OtherSTATE LIC
WASC5663OtherKING COUNTY
WASC5663OtherKING COUNTY