Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD00018830 | WA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD000188830 | WA |
NPI | 1063432888 |
---|---|
Provider Name | Dr. Kevin Peter Schoenfelder |
First Address | Tacoma, WA 98405-3933 |
Second Address | Tacoma, WA 98405-3933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 14/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0236632 | STATE L&I (01) | WA |
1005842 | (05) | WA |
88874 | LABOR/INDUSTRIES NUMBER (01) | WA |
A17107 | (02) | WA |
SC7664 | REGENCE PROVIDER NUMBER (01) | WA |