Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301088432 | MI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 60148265 | WA |
NPI | 1174735690 |
---|---|
Provider Name | Heather Louise Schuback |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 22/07/2013 |