Provider Demographics
NPI:1144327289
Name:SCHLAFFMAN, RIKK JEREMY (OD)
Entity type:Individual
Prefix:MR
First Name:RIKK
Middle Name:JEREMY
Last Name:SCHLAFFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 S MERIDIAN STE 101
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-7590
Mailing Address - Country:US
Mailing Address - Phone:253-848-3000
Mailing Address - Fax:253-840-6514
Practice Address - Street 1:1703 S MERIDIAN STE 101
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-7590
Practice Address - Country:US
Practice Address - Phone:253-848-3000
Practice Address - Fax:253-840-6514
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABL0500877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2105807Medicaid
WA0337210001OtherDMERC PROVIDER NUMBER
WASC7561OtherREGENCE PROVIDER NUMBER
WA0337210001OtherDMERC PROVIDER NUMBER
WASC7561OtherREGENCE PROVIDER NUMBER
WA001001457Medicare ID - Type UnspecifiedPART B