Provider Demographics
NPI:1730351479
Name:SCHREIBER, JEANNETTE M (LAC)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:M
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1573
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0180
Mailing Address - Country:US
Mailing Address - Phone:408-799-4849
Mailing Address - Fax:
Practice Address - Street 1:18870 8TH AVE NE STE 108
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6233
Practice Address - Country:US
Practice Address - Phone:360-394-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11245171100000X
WAAC 60173357171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist