Provider Demographics
NPI:1194152603
Name:SCHREPEL, IREATHA LANE (HAS)
Entity type:Individual
Prefix:MRS
First Name:IREATHA
Middle Name:LANE
Last Name:SCHREPEL
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 EMERALD HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-9596
Mailing Address - Country:US
Mailing Address - Phone:360-425-0730
Mailing Address - Fax:360-425-0735
Practice Address - Street 1:950 11TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2504
Practice Address - Country:US
Practice Address - Phone:360-425-0730
Practice Address - Fax:360-425-0735
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-28
Last Update Date:2013-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA60247125237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist