Provider Demographics
NPI:1487120473
Name:SCHMITT, NOLAN NICHOLAS (DPT)
Entity type:Individual
Prefix:
First Name:NOLAN
Middle Name:NICHOLAS
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 ST HELENS AVE APT 509
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-2586
Mailing Address - Country:US
Mailing Address - Phone:920-210-6102
Mailing Address - Fax:
Practice Address - Street 1:2323 JENSEN ST
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-3605
Practice Address - Country:US
Practice Address - Phone:360-825-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14403-24225100000X
WAPT60890034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist