Provider Demographics
NPI:1649486929
Name:PAULA L SCHULZE MD INC PS
Entity type:Organization
Organization Name:PAULA L SCHULZE MD INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHULZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-759-3586
Mailing Address - Street 1:2517 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5841
Mailing Address - Country:US
Mailing Address - Phone:253-759-3586
Mailing Address - Fax:253-759-5746
Practice Address - Street 1:2517 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-5841
Practice Address - Country:US
Practice Address - Phone:253-759-3586
Practice Address - Fax:253-759-5746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1095397Medicaid
WA1095397Medicaid
WAGAB10513Medicare PIN