Provider Demographics
NPI:1063432888
Name:SCHOENFELDER, KEVIN PETER (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:PETER
Last Name:SCHOENFELDER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3933
Mailing Address - Country:US
Mailing Address - Phone:253-272-0186
Mailing Address - Fax:253-272-2642
Practice Address - Street 1:1515 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3933
Practice Address - Country:US
Practice Address - Phone:253-272-0186
Practice Address - Fax:253-272-2642
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018830207X00000X
WAMD000188830207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0236632OtherSTATE L&I
WA1005842Medicaid
WASC7664OtherREGENCE PROVIDER NUMBER
WA88874OtherLABOR/INDUSTRIES NUMBER
WAG8873898Medicare PIN
WA0236632OtherSTATE L&I
WAA17107Medicare UPIN