Provider Demographics
NPI:1730367368
Name:SCHEUFFELE, LISA ANN (PT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:SCHEUFFELE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-0306
Mailing Address - Country:US
Mailing Address - Phone:253-549-7008
Mailing Address - Fax:
Practice Address - Street 1:525 6TH AVE.
Practice Address - Street 2:
Practice Address - City:FOX ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98333-0306
Practice Address - Country:US
Practice Address - Phone:253-549-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist