Provider Demographics
NPI:1912107459
Name:SCHWABE, PAUL L (MT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:SCHWABE
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FORT STREET
Mailing Address - Street 2:PO BOX 410
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357
Mailing Address - Country:US
Mailing Address - Phone:360-645-2233
Mailing Address - Fax:360-645-2723
Practice Address - Street 1:250 FORT STREET
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:360-645-2723
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA124361247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician