Provider Demographics
NPI:1770945065
Name:SCHOWALTER, KAREN (DO)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SCHOWALTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 N 26TH ST UNIT 115
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-2415
Mailing Address - Country:US
Mailing Address - Phone:253-756-3737
Mailing Address - Fax:360-744-5123
Practice Address - Street 1:5741 N 26TH ST UNIT 115
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-2415
Practice Address - Country:US
Practice Address - Phone:253-756-3737
Practice Address - Fax:360-744-5123
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60958257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2064738Medicaid