Provider Demographics
NPI:1235253717
Name:SCHWARTZKOPF, JOEL W (PA-C)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:W
Last Name:SCHWARTZKOPF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 NE 50TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2903
Mailing Address - Country:US
Mailing Address - Phone:307-575-1300
Mailing Address - Fax:
Practice Address - Street 1:WASHINGTON BUILDING 642303
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99164-7282
Practice Address - Country:US
Practice Address - Phone:509-335-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY408363A00000X
COPA.0002917363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11184337Medicaid
WYW21181Medicare PIN
CO11184337Medicaid
Q76852Medicare UPIN