Provider Demographics
NPI:1073573838
Name:SCHAETZEL-HILL, K BURNELL (DO)
Entity type:Individual
Prefix:DR
First Name:K BURNELL
Middle Name:
Last Name:SCHAETZEL-HILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 ENSIGN RD NE
Mailing Address - Street 2:STE. F
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506
Mailing Address - Country:US
Mailing Address - Phone:360-438-3029
Mailing Address - Fax:360-438-8585
Practice Address - Street 1:3525 ENSIGN RD NE
Practice Address - Street 2:STE. F
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506
Practice Address - Country:US
Practice Address - Phone:360-438-3029
Practice Address - Fax:360-438-8585
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1107994Medicaid
WA50D0969721OtherCLIA#
WA0174338OtherLABOR AND INDUSTRIES#
WA1107994OtherDSHS#
WA1107994OtherDSHS#
WABS2765103OtherDEA#
WA1107994Medicaid