Basic Information
| Provider Information | |||||||||
| NPI: | 1588010763 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHOLLENBERGER | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10115 HOLLY DR | ||||||||
| Address2: | APT D107 | ||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982048717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255306072 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3214 W MCGRAW ST | ||||||||
| Address2: | STE 212 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981993239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064534882 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2016 | ||||||||
| LastUpdateDate: | 10/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | CG60660527 | WA | Y |
No ID Information.