Provider Demographics
NPI:1386603090
Name:SCHMIDT, WILLETTE MARIE
Entity type:Individual
Prefix:MS
First Name:WILLETTE
Middle Name:MARIE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E 5TH
Mailing Address - Street 2:THOMPSON CUSTOM ORTHOTIC AND PROSTHETIC
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1313
Mailing Address - Country:US
Mailing Address - Phone:509-624-1308
Mailing Address - Fax:509-624-5537
Practice Address - Street 1:502 E 5TH
Practice Address - Street 2:THOMPSON CUSTOM ORTHOTIC AND PROSTHETIC
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1313
Practice Address - Country:US
Practice Address - Phone:509-624-1308
Practice Address - Fax:509-624-5537
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOI00000348222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02576OtherAMERICAN BOARD FOR CERT O