Provider Demographics
NPI:1215697024
Name:SCHNEIDER, LINDA LEE (RN CDMS CCM)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:RN CDMS CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 UPLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-9296
Mailing Address - Country:US
Mailing Address - Phone:360-225-6682
Mailing Address - Fax:
Practice Address - Street 1:112 UPLAND DR
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9296
Practice Address - Country:US
Practice Address - Phone:360-225-6682
Practice Address - Fax:360-225-6647
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR079043777RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse