Provider Demographics
NPI:1548648744
Name:SCHNEIDER, COREY (LMT)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:SARAI
Other - Middle Name:DANIELLE
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10214 30TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-1222
Mailing Address - Country:US
Mailing Address - Phone:415-812-2284
Mailing Address - Fax:
Practice Address - Street 1:10214 30TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-1222
Practice Address - Country:US
Practice Address - Phone:415-812-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60644517225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist