Provider Demographics
NPI:1598018855
Name:SCHIELKE, CLARISA MARIE (M ED, OTR/L,)
Entity type:Individual
Prefix:MS
First Name:CLARISA
Middle Name:MARIE
Last Name:SCHIELKE
Suffix:
Gender:F
Credentials:M ED, OTR/L,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5222 S MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6529
Mailing Address - Country:US
Mailing Address - Phone:509-354-6350
Mailing Address - Fax:
Practice Address - Street 1:5222 S MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-6529
Practice Address - Country:US
Practice Address - Phone:509-354-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001725174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist