Provider Demographics
NPI:1912131004
Name:SCHROFF, VICTORIA E (MT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:E
Last Name:SCHROFF
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23925 225TH WAY SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5233
Mailing Address - Country:US
Mailing Address - Phone:425-433-0123
Mailing Address - Fax:425-433-0733
Practice Address - Street 1:17615 SE 272ND ST
Practice Address - Street 2:SUITE 110
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4957
Practice Address - Country:US
Practice Address - Phone:253-639-2266
Practice Address - Fax:253-639-8464
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60074737225700000X
NVNVMT2751225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist