Provider Demographics
NPI:1295086221
Name:SCHULTZ, RENATE CHRISTINE
Entity type:Individual
Prefix:MS
First Name:RENATE
Middle Name:CHRISTINE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 N PROCTOR ST STE 448
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5338
Mailing Address - Country:US
Mailing Address - Phone:707-302-8233
Mailing Address - Fax:253-793-0338
Practice Address - Street 1:9340 NE 76TH STREET
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662
Practice Address - Country:US
Practice Address - Phone:707-302-0338
Practice Address - Fax:253-793-0338
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60584159103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical