Provider Demographics
NPI:1144074238
Name:SCHILDER, AMY (MC61469908)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SCHILDER
Suffix:
Gender:F
Credentials:MC61469908
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6037 MT BAKER HWY
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:WA
Mailing Address - Zip Code:98244-9551
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6037 MT BAKER HWY
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:WA
Practice Address - Zip Code:98244-9551
Practice Address - Country:US
Practice Address - Phone:713-444-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61469908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health