Provider Demographics
NPI:1831565860
Name:SCHREPFERMAN, DOUG
Entity type:Individual
Prefix:
First Name:DOUG
Middle Name:
Last Name:SCHREPFERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 18TH AVE
Mailing Address - Street 2:#101
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2767
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1729 18TH AVE
Practice Address - Street 2:#101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2767
Practice Address - Country:US
Practice Address - Phone:307-899-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health