Provider Demographics
NPI:1932599727
Name:SCHADLER, LORI A (PTA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:SCHADLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16709 NE 10TH WAY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6423
Mailing Address - Country:US
Mailing Address - Phone:360-883-2646
Mailing Address - Fax:
Practice Address - Street 1:16709 NE 10TH WAY
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6423
Practice Address - Country:US
Practice Address - Phone:360-883-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-31
Last Update Date:2015-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP1 60031543225200000X
OR08123225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant