Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT 00005272 | WA |
NPI | 1033463419 |
---|---|
Provider Name | Lynn R Schafer |
First Address | Edmonds, WA 98026-6627 |
Second Address | Edmonds, WA 98026-6627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2012 |
Last Update Date | 06/11/2012 |