Provider Demographics
NPI:1932925161
Name:SCHACHLE, VICTORIA JEAN (LMT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JEAN
Last Name:SCHACHLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 S DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-0750
Mailing Address - Country:US
Mailing Address - Phone:907-841-4711
Mailing Address - Fax:
Practice Address - Street 1:231 E SWANSON AVE STE 28
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7056
Practice Address - Country:US
Practice Address - Phone:907-521-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK227388225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist