Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | MD00046196 | WA |
NPI | 1134169683 |
---|---|
Provider Name | Peter R. Schmidt |
First Address | Seattle, WA 98124-0584 |
Second Address | Renton, WA 98055-5714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 04/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0208772 | LABOR&INDUSTRIES PROV NUM (01) | WA |
8454688 | (05) | WA |