Provider Demographics
NPI:1831588136
Name:SCHILTZ, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SCHILTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4652 ELSICA DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:WA
Mailing Address - Zip Code:98236-9512
Mailing Address - Country:US
Mailing Address - Phone:360-341-1980
Mailing Address - Fax:
Practice Address - Street 1:4652 ELSICA DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:WA
Practice Address - Zip Code:98236-9512
Practice Address - Country:US
Practice Address - Phone:360-341-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU 00000998133N00000X
WARN 00119428163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No163W00000XNursing Service ProvidersRegistered Nurse