Provider Demographics
NPI:1881011245
Name:SCHMIDT FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:SCHMIDT FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:425-258-1969
Mailing Address - Street 1:4418 RUCKER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2397
Mailing Address - Country:US
Mailing Address - Phone:425-258-1969
Mailing Address - Fax:
Practice Address - Street 1:4418 RUCKER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2397
Practice Address - Country:US
Practice Address - Phone:425-258-1969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000715111N00000X
WACH00034132111N00000X
WACH00003202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU61482Medicare UPIN
WAT03054Medicare UPIN
U906078Medicare UPIN