Provider Demographics
NPI:1366541161
Name:SCHMIDT, PAUL WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WILLIAM
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7210 40TH ST W STE 100
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4319
Mailing Address - Country:US
Mailing Address - Phone:253-564-0170
Mailing Address - Fax:253-207-4240
Practice Address - Street 1:7210 40TH ST W STE 100
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4319
Practice Address - Country:US
Practice Address - Phone:253-564-0170
Practice Address - Fax:253-207-4240
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0290075OtherSTATE L&I
WA1008761Medicaid