Provider Demographics
NPI:1831804038
Name:SCHROEDER, MATTHEW SCOTT (OD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SCOTT
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-7848
Mailing Address - Country:US
Mailing Address - Phone:360-452-4056
Mailing Address - Fax:
Practice Address - Street 1:901 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-7848
Practice Address - Country:US
Practice Address - Phone:360-452-4056
Practice Address - Fax:360-457-1686
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD61432392152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist