Provider Demographics
NPI:1114773918
Name:SCHREIBER, DAVID (PTA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N 41ST ST APT D
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-1237
Mailing Address - Country:US
Mailing Address - Phone:605-270-3285
Mailing Address - Fax:
Practice Address - Street 1:9501 W CLEARWATER AVE STE A130
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8640
Practice Address - Country:US
Practice Address - Phone:509-241-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61090028208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation