Basic Information
| Provider Information | |||||||||
| NPI: | 1770945065 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHOWALTER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5741 N 26TH ST UNIT 115 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984072415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537563737 | ||||||||
| FaxNumber: | 3607445123 | ||||||||
| Practice Location | |||||||||
| Address1: | 5741 N 26TH ST UNIT 115 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984072415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537563737 | ||||||||
| FaxNumber: | 3607445123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2016 | ||||||||
| LastUpdateDate: | 12/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OP60958257 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2064738 | 05 | WA | MEDICAID |