Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60827169 | WA |
NPI | 1013415728 |
---|---|
Provider Name | Jennifer Megan Schladweiler |
First Address | Seattle, WA 98115-4064 |
Second Address | Seattle, WA 98115-2042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2018 |
Last Update Date | 28/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AP60827169 | WASHINGTON STATE DEPARTMENT OF HEALTH (01) | WA |
RN60242137 | WASHINGTON STATE DEPARTMENT OF HEALTH (01) | WA |